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Toward Clinical Pharmacologic Otoprotection
Published in Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm, Advances in Audiology and Hearing Science, 2020
Colleen G. Le Prell, Kelly Roth, Kathleen C. M. Campbell
Lactated Ringers solution is a sterile, nonpyrogenic solution used for fluid and electrolyte replacement. It cannot be administered simultaneously with calcium-containing infusion solutions, such as the drug ceftriaxone. There are a number of patient populations for which LR should not be administered and some populations may require clinical evaluation and periodic laboratory assessment to monitor changes in fluid balance, electrolyte concentrations, or acid–base balance. LR is administered under physician oversight.
Methods and Procedures
Published in Richard A. Jonas, Jane W. Newburger, Joseph J. Volpe, John W. Kirklin, Brain Injury and Pediatric Cardiac Surgery, 2019
Jane W. Newburger, Wypij David
Cardiopulmonary bypass was terminated at a rectal temperature of 36°C after a dopamine infusion of 5 µg/kg/min was started and satisfactory perfusion pressures were achieved. When necessary, higher dopamine infusion rates were used. Our clinical experience with neonates undergoing low-flow bypass had revealed that patients who rewarm rapidly to this temperature have a marked tendency to drop their body temperature to as low as 32°C within 10 to 15 minutes of weaning from bypass. Our practice, therefore, was to have a minimum rewarming period of 30 minutes. The surgeon must also have believed that satisfactory myocardial function had been regained and that all aspects of the procedure had been completed. Cardiac filling pressures were maintained at levels necessary to give arterial systolic perfusion pressures of at least 60 mmHg. We administered Lactated Ringers solution at 10 mL/kg/h, as well as blood and blood products as indicated to maintain filling pressures. Calcium and other electrolytes were administered to maintain serum values within the normal ranges. We measured arterial blood gases, hematocrit, electrolytes, glucose, and osmolarity within 15 minutes after cessation of bypass and additionally as needed. CPK levels were measured 1.5 hours after resumption of bypass if the patient was still in the operating room. No other anesthetic drugs were administered. Additional doses of Fentanyl or Pancuronium were administered only if clinically indicated.
Small Animal Handling, Care, and Anesthesia
Published in George C. Kagadis, Nancy L. Ford, Dimitrios N. Karnabatidis, George K. Loudos, Handbook of Small Animal Imaging, 2018
Preoperative or preanesthesia administration of fluids given subcutaneously may be beneficial for long-duration anesthesia or debilitated small rodents. Fluids may also be provided during the imaging session, especially if intravenous access has been obtained with a catheter. Lactated ringers solution or 0.9% sodium chloride can be given intravenously, subcutaneously, or intraperitoneally at a rate of 5–10 mL/kg/h (Harkness et al. 2010). Fluids should be warmed as cold fluids can cause hypothermia. Syringe drivers or syringe infusion pumps may be very useful at delivering these small volumes. Rodents will require 40–80 mL/kg/day of fluids in the postimaging period until it is certain that the animal is eating and drinking sufficiently.
The impact of supportive care on survival in large animal models of total body irradiation
Published in International Journal of Radiation Biology, 2021
Karla D. Thrall, Saikanth Mahendra, Jamie Lovaglio, M. Keven Jackson
Vascular access port (VAP) implant procedures were adapted from a technique described by Moroni et al. (2011c). Briefly, minipigs were anesthetized with ketamine (33 mg kg−1 subcutaneous (SC)) and acepromazine (1.1 mg kg−1 SC), then intubated and maintained on isoflurane (1.5-3%) anesthesia. Venous access was established with a 22-gauge intravenous catheter placed in the lateral saphenous or auricular vein. Pre-operatively, all minipigs received a single dose of ampicillin (6 mg kg−1 intravenous (IV)) and buprenorphine (0.05 mg kg−1 intramuscular (IM)). Intra-operatively, all minipigs received lactated ringers solution at a rate of approximately 5–10 ml kg−1 h−1 through the intravenous catheter. Strict aseptic technique was utilized throughout the surgical procedure.
Through-the-needle biopsy of pancreatic cystic lesions: current evidence and implications for clinical practice
Published in Expert Review of Medical Devices, 2021
Antonio Facciorusso, Daryl Ramai, Paraskevas Gkolfakis, Alexandra Shapiro, Marianna Arvanitakis, Andrea Lisotti, Konstantinos Triantafyllou, Pietro Fusaroli, Ioannis S Papanikolaou, Stefano Francesco Crinò
Steps toward developing data to evaluate AE are described in the aforementioned study by Kovacevic et al. Results identified no predictive factors for AEs, nor were any relationships between AEs and procedural features observed. Measured procedural features included procedure time, intra-cystic needle time, and the number of passes [42]. However, lack of significant association between baseline parameters and final events is likely attributable to the relatively small sample size. Of note, all reported AEs occurred in patients with IPMNs, though analysis did not result in a statistically significant correlation (p = 0.19). The protocol was amended after 3 months of enrollment to include additional interventions aimed at reducing the rate of AEs. Additions include perioperative hydration with 1 L of Lactated Ringers solution, and the administration of rectal diclofenac 100 mg. These interventions resulted in a substantial reduction in the AE rate from 17.6% to 8.3% [42].
Localized delivery of therapeutic doxorubicin dose across the canine blood–brain barrier with hyperthermia and temperature sensitive liposomes
Published in Drug Delivery, 2018
Amy Lee Bredlau, Anjan Motamarry, Chao Chen, M. A. McCrackin, Kris Helke, Kent E. Armeson, Katrina Bynum, Ann-Marie Broome, Dieter Haemmerich
All dogs were assessed by physical examination, complete blood count, and clinical chemistry. They were treated with oral antihistamines (famotidine, 0.5 mg/kg once daily; diphenhydramine, 2 mg/kg TID) and steroids (prednisone, 0.5 mg/kg BID) for 24 h before nonsurvival and 2 d before and 1 d after survival surgery to prevent allergic reactions to the liposomes. On the day of surgery, dogs were pre-anesthetized intramuscular (IM) with midazolam (0.25 mg/kg) and buprenorphine (0.05 mg/kg), a 22-gauge intravenous (IV) cephalic catheter was placed, and anesthesia was induced IV with propofol (4.7 mg/kg, to effect). Dogs were intubated and maintained under anesthesia with isoflurane in 100% O2 using a mechanical ventilator. Supportive care included lactated ringers solution (LRS) (10 ml/kg/h IV) through the cephalic catheter, external thermal support, and perioperative antibiotics (survival surgery only; cefazolin 22 mg/kg IV 30 min before incision and every 90 min thereafter until incision closure). The external thermal support was adjusted to keep the body temperature below 37 °C to limit systemic leakage of doxorubicin from TSL. A 19 gauge, 8-inch catheter (Intracath; Argon Medical, Athens, TX) was placed percutaneously into the right jugular vein for serial sample collections for pharmacokinetics (PK) analysis. Bupivacaine 0.5% (1 mg/4.5 kg) was infused subcutaneously (SC) along the dorsal midline of the head where the skin incision was planned. Additional antihistamines (famotidine, 0.5 mg/kg; diphenhydramine, 2 mg/kg) and steroids (dexamethasone, 2 mg/kg) were given IV before TSL-dox infusion.