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Complications of Equine Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Fluid choices include (see Chapter 8): Isotonic-balanced crystalloid solutions in large volumes.Hypertonic saline in conjunction with isotonic solutions.Colloids.Blood products if hemorrhage has occurred.
A Guide to Use of Crystalloids
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Jeetinder Kaur Makkar, Mandeep Tundak
Saline. A 0.9% solution of saline is isotonic, but it has supraphysiological concentration of chloride. It is widely used because of cheaper availability. It is devoid of calcium, so blood can be transfused along with it. Because of the isotonic nature, it is used as the first fluid in neurotrauma patients. Serious complications occur if more than two litres of isotonic saline is used. Complications include hyperchloremic metabolic acidosis and abdominal pain. Hypertonic saline (HTS) (3% or 7.5%) can be used in hypotensive neurotrauma patients where massive crystalloid administration can lead to more harm than benefit. Compared to isotonic crystalloid, use of permissive hypotension with HTS in patients undergoing damage control surgery resulted in reduced 30-day mortality; increased urine output; and reduced risk of acute respiratory distress syndrome, sepsis and organ failure. HTS is beneficial in patients with brain oedema, traumatic brain injury (TBI), or massive haemorrhage requiring damage control surgery. HTS is associated with increased renal failure, need for renal replacement therapy and mortality.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Fluids that may be given to patients by intravenous (IV) infusion may be: Isotonic (having the same concentrations as body cells).Hypertonic (having a higher concentration than body cells)Hypotonic (having a lower concentration than body cells).
Success of the acute renal angina index in the early prediction of acute kidney injury in the emergency department
Published in Acta Clinica Belgica, 2023
Raziye Merve Yaradilmiş, Betül Öztürk, Ali Güngör, İlknur Bodur, Muhammed Mustafa Güneylioğlu, Aytaç Göktuğ, Aysun Tekeli, Can Demir Karacan, Nilden Tuygun
AKI is a complex multivariate syndrome, with sepsis as one of the most common causes [2]. Although sepsis-associated AKI is common, the underlying pathophysiological mechanisms are poorly understood. One of the accepted mechanisms involves decreased renal blood flow and consequent tubular epithelial cell death or acute tubular necrosis [16]. In our study, the leading causes of AKI (sepsis, septic shock, acute gastroenteritis, and diabetic ketoacidosis-associated hypovolemic shock) were associated with hypoperfusion and shock. Early and late findings of shock (tachycardia, prolonged capillary refill time, and hypotension) in multivariate logistic regression analysis support the role of renal hypoperfusion in the ischemic process leading to kidney injury. In addition, the most important factors increasing the risk of kidney injury were received isotonic fluids in the PED and admitted to an intensive care unit. This is likely a reflection of the illness severity and clinicians should be aware of kidney injuries in critically ill children, especially if there are signs of inadequate perfusion.
Pirfenidone as a potential antifibrotic injectable for Dupuytren’s disease
Published in Pharmaceutical Development and Technology, 2022
Suchitra Panigrahi, Amanda Barry, Scott Multner, Gerald B. Kasting, Julio A. Landero Figueroa, Latha Satish, Harshita Kumari
Furthermore, to avoid pain, the injections are (a) typically adjusted to obtain isotonic solutions; and/or (b) used in small volumes. The sensitivity of hypertonicity-induced pain clearly varies depending on the tissue types and sites of injection (Wang 2015). In our case, the final product (Table 3) was hypertonic (tonicity cannot be adjusted for hypertonic solutions), i.e. higher than recommended upper limit of 600 mOsm/kg (Jørgensen et al. 1996; Wang 2015; Usach et al. 2019), but the injection volume was low (∼0.4 mL) (Jørgensen et al. 1996; Usach et al. 2019) and expected to mitigate the pain at the injection site (Svendsen et al. 2005). The product must be sterile before injection; therefore, the PFD injectable solution was sterilized by filtration. As PFD is slightly heat-sensitive with a melting point of 110.25 °C, terminal dry heating or steam sterilization might not be suitable and could degrade the solution. Therefore, sterilization by filtration using a Millex-GV PVDF syringe filter, which is highly non-reactive and hydrophilic, is appropriate.
Isotonic versus hypotonic saline as maintenance intravenous fluid therapy in children under 5 years of age admitted to general paediatric wards: a randomised controlled trial
Published in Paediatrics and International Child Health, 2020
Manish Kumar, Kaustav Mitra, Rahul Jain
The primary outcome variable was to compare the incidence of hyponatraemia in children receiving 0.45% saline in 5% dextrose with those receiving 0.9% saline in 5% dextrose (subsequently referred to as half normal saline and normal saline, respectively). Hyponatraemia was defined as serum sodium <135 mmol/L with a decrease of at least 4 mmol/L from baseline [9]. ‘Hypotonic’ and ‘isotonic’ will be used for half normal saline and normal saline, respectively. The secondary outcome variables were comparison of the incidence of moderate (serum sodium <130 mmol/L), severe (serum sodium <125 mmol/L) and symptomatic hyponatraemia (lethargy, altered sensorium or seizures), difference in mean serum sodium level at 12 and 24 h, change in serum sodium level from baseline and the incidence of hypernatraemia (serum sodium >145 mmol/L) in the two groups.