Acute and Critical Care

Review Article

Nutrition
Fluid management in perioperative and critically ill patients: Dongho Kang, Kyung Yeon Yoo; Acute Crit Care. 2019;34(4):235-245. Published online November 29, 2019; DOI: https://doi.org/10.4266/acc.2019.00717

11,238 View
889 Download
12 Web of Science
11 Crossref

Fluid therapy to restore and/or maintain tissue perfusion may affect patient outcomes in perioperative, emergency, and intensive care. Kinetic analyses and outcome-oriented studies have provided more insight into fluid management. Crystalloids are slowly distributed to the interstitial space, and the efficiency (proportion of infused fluid retained in the bloodstream) is 50%−75% as long as infusion continues and may increase up to 100% when the arterial pressure has decreased. Elimination of the infused fluid during general anesthesia and surgery is very slow, amounting to only 10%–20% compared with that in conscious patients. When the endothelial glycocalyx layer is degraded in sepsis or trauma-induced systemic inflammation, turnover of colloids and crystalloids is accelerated and the efficiency is reduced, which may lead to tissue edema, inflammation, poor wound healing, and organ dysfunction. Balanced crystalloids are pragmatic initial resuscitation fluids and improve patient outcomes compared to saline (0.9% sodium chloride). Albumin may be beneficial, but other synthetic colloids appear to increase the risk of acute kidney injury and death among patients in the intensive care unit. Fluid kinetics is likely to change based on patient physiological conditions (e.g., general anesthesia, surgery, stress, dehydration, blood pressure, or inflammation) and fluid types. To maximize efficacy and minimize iatrogenic side effects, fluids should be prescribed based on individual patient factors, disease states, and other treatment remedies.

Citations

Citations to this article as recorded by

Pulse pressure variation guided goal-direct fluid therapy decreases postoperative complications in elderly patients undergoing laparoscopic radical resection of colorectal cancer: a randomized controlled trial
Qiu-Rong Wu, Zi-Zuo Zhao, Ke-Ming Fan, Hui-Ting Cheng, Bin Wang
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Prevalence and associated factors of postoperative orthostatic intolerance at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2022: cross sectional study
Negesse Zurbachew Gobezie, Nigussie Simeneh Endalew, Hailu Yimer Tawuye, Habtu Adane Aytolign
BMC Surgery.2023;[Epub] CrossRef
Remimazolam and serious adverse events
Sander Kempenaers, Tom G. Hansen, Marc Van de Velde
European Journal of Anaesthesiology.2023; 40(11): 841. CrossRef
The incidence and risk factors of proximal lower extremity deep vein thrombosis without pharmacologic prophylaxis in critically ill surgical Taiwanese patients: A prospective study
Ting-Lung Lin, Wen-Hao Liu, Wei-Hung Lai, Ying-Ju Chen, Po-Hsun Chang, I-Ling Chen, Wei-Feng Li, Yueh-Wei Liu, Eric J Ley, Chih-Chi Wang
Journal of the Intensive Care Society.2023;[Epub] CrossRef
Meropenem pharmacokinetics in critically ill patients with or without burn treated with or without continuous veno‐venous haemofiltration
Daniel J. Selig, Kevin S. Akers, Kevin K. Chung, Kaitlin A. Pruskowski, Jeffrey R. Livezey, Elaine D. Por
British Journal of Clinical Pharmacology.2022; 88(5): 2156. CrossRef
Does perioperative fluid management affect the development of postoperative complications in major gastrointestinal tract surgery? A retrospective cohort study
Mehmet Mustafa ALTINTAŞ, Kemal Tolga SARAÇOĞLU, Aytaç Emre KOCAOĞLU, Fırat MÜLKÜT, Ayten SARACOĞLU, Selçuk KAYA, Ayhan ÇEVİK
Journal of Surgery and Medicine.2022; 6(2): 90. CrossRef
A Porcine Sepsis Model With Numerical Scoring for Early Prediction of Severity
Attila Rutai, Bettina Zsikai, Szabolcs Péter Tallósy, Dániel Érces, Lajos Bizánc, László Juhász, Marietta Zita Poles, József Sóki, Zain Baaity, Roland Fejes, Gabriella Varga, Imre Földesi, Katalin Burián, Andrea Szabó, Mihály Boros, József Kaszaki
Frontiers in Medicine.2022;[Epub] CrossRef
Risk Factors for and Outcomes Associated With Peri-Intubation Hypoxemia: A Multicenter Prospective Cohort Study
Nathan J. Smischney, Ashish K. Khanna, Ernesto Brauer, Lee E. Morrow, Uchenna R. Ofoma, David A. Kaufman, Ayan Sen, Chakradhar Venkata, Peter Morris, Vikas Bansal
Journal of Intensive Care Medicine.2021; 36(12): 1466. CrossRef
Inflammatory response, fluid balance and outcome in emergency high‐risk abdominal surgery
Mirjana Cihoric, Henrik Kehlet, Morten L. Lauritsen, Jakob Højlund, Katrine Kanstrup, Nicolai B. Foss
Acta Anaesthesiologica Scandinavica.2021; 65(6): 730. CrossRef
A review on the physiological and pathophysiological role of endothelial glycocalyx
Huan‐qiu Liu, Ji Li, Cheng‐luan Xuan, Hai‐chun Ma
Journal of Biochemical and Molecular Toxicology.2020;[Epub] CrossRef
Science‐in‐brief: The role of the glycocalyx in critically ill patients with reference to the horse
Bettina Dunkel
Equine Veterinary Journal.2020; 52(6): 790. CrossRef

Case Reports

Pharmacology/Anesthesiology
Lipid Emulsion in the Successful Resuscitation of Local Anesthetic Toxicity after Ankle Block: Sang Hee Park, Sang Hyun Kwak, Kyung Yeon Yoo, Hyun Jung Lee, Keun Bae Yook, Seok Jai Kim; Korean J Crit Care Med. 2014;29(3):234-236. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.234

6,228 View
96 Download

Abstract PDF: Unexpected occurrence of local anesthetic toxicity is not rare and can cause fatal complications that do not respond to any known drug of intervention. Recently, the successful use of lipid emulsion for local anesthetic toxicity has been reported and recommended as a rescue method for cardiac or neurologic complications. We report a case of seizure attack and respiratory arrest successfully recovered with the use of intravenous lipid emulsion. Clinicians must be aware of the beneficial role of lipid emulsion in cases of local anesthetic toxicity.

Vocal Cord Paralysis after the Coronary Artery Bypass Graft: A Case Report: Kwang Su Kim, Seong Wook Jeong, Sang Hyun Kwak, Myung Ha Yoon, Kyung Yeon Yoo, Chang Young Jeong, Sung Su Chung; Korean J Crit Care Med. 2005;20(2):170-173.

1,640 View
21 Download

Abstract PDF: Surgical trauma has long been recognized as the most common cause of unilateral and bilateral vocal cord paralysis. We experienced a case of bilateral vocal cord paralysis after off-pump coronary artery bypass graft. The patient was repeated intubation and extubation after operation in surgical intensive care unit. Fiberoptic bronchoscopy revealed bilateral vocal cord paralysis in the patient. The patient recovered after permanent tracheotomy. We reported a case of vocal cord paralysis after coronary artery bypass graft.

Randomized Controlled Trial

Effects of Alfentanil on Hemodynamic and Catecholamine Responses to Laryngoscopy and Endobronchial Intubation in the Elderly: Kyung Yeon Yoo, Sung Su Chung, Myung Ha Yoon, Seong Wook Jeong, Jeong Il Choi, Chang Young Jeong; Korean J Crit Care Med. 2005;20(2):114-120.

1,442 View
14 Download

Abstract PDF: BACKGROUND
Endobronchial intubation should elicit significant circulatory responses. We examined the effects of alfentanil on hemodynamic and catecholamine responses to endobronchial intubation in elderly patients. METHODS: A total of 60 patients aged over 60 years requiring endobronchial intubation were randomized into three groups of 20 patients each. Anesthesia was induced with thiopental 4~6 mg/kg followed by saline (placebo) or alfentanil 10 or 30microgram/kg given as a bolus over 30 s. Succinylcholine 1 mg/kg was given for neuromuscular block. Laryngoscopy and intubation were performed 1 min later. RESULTS: The intubation significantly increased systolic arterial pressure and heart rate. The maximum pressure changes from pre-intubation values in both alfentanil groups (58+/-27 and 33+/-30 mm Hg in 10 and 30microgram/kg, respectively) were significantly lower compared with that of 83+/-35 mm Hg in the control group. The tachycardiac response was not significantly affected by alfentanil 10microgram/kg, but attenuated by alfentanil 30microgram/kg. The plasma norepinephrine concentrations were increased, which was not affected by alfentanil 10microgram/kg, but was significantly attenuated by alfentanil 30microgram/kg. Both doses of alfentanil abolished the increase of plasma epinephrine concentrations. Three patients in the 30microgram/kg group received ephedrine for hypotension. CONCLUSIONS: This study showed that endobronchial intubation elicited significant pressor response, and that alfentanil 30microgram/kg is more efficacious in attenuating the hemodynamic and catecholamine responses, although potential hypotension warrants a caution of its use, in elderly patients.

Case Report

Re-expansion Pulmonary Edema after Chest Tubing: A Case Report: Seong Wook Jeong, Chang Mo Kim, Cheol Hun Choi, Dong Jin Shin, Hong Beom Bae, Sung Su Chung, Kyung Yeon Yoo, Chang Young Jeong; Korean J Crit Care Med. 2005;20(1):87-91.

1,685 View
86 Download

Abstract PDF: Re-expansion pulmonary edema (RPE) is a rare complication associated with the treatment of collapsed lung caused by pneumothorax, atelectasis, pleural effusion in which a large amount of air or effusion fluid is evacuated. In general RPE is resulted from more than 3 days of lung collapse and application of high negative intrapleural pressure. However, it is reported that RPE could be developed despite the collapse period is short and negative pressure suction is not performed. It also has been known that the rate of reexpansion is more important than amount of evacuated air, or collapse period in the development of RPE. Seventeen-year-old female was undergone suture hemostasis for liver laceration, in which RPE was occurred after closed thoracostomy for pleural effusion on postoperative-27 day. We present a case report with review of related articles.

Original Articles

Effects of Amrinone and Dobutamine on Regional Myocardial Function and Oxygen Balance in Normal and Stunned Myocardium in Dogs: Jun Suh Park, Jong Eun Park, Sung Tae Jeong, Seongwook Jeong, Sung Su Chung, Kyung Yeon Yoo; Korean J Crit Care Med. 2005;20(1):14-23.

1,562 View
18 Download

Abstract PDF: BACKGROUND
We examined the effects of amrinone and dobutamine on regional mechanical function, coronary blood flow (CBF), and myocardial oxygen consumption (MVO2) in normal and stunned myocardium in an open-chest canine model.
METHODS
Dogs were instrumented to measure aortic and left ventricular pressures, pulmonary and left anterior descending (LAD) coronary blood flows, and subendocardial segment length in the region supplied by LAD. Incremental doses of either amrinone (2~10microgram/ml of LAD flow, n=13) or dobutamine (0.05~0.375microgram/ml of LAD flow, n=14) were directly infused into a coronary artery before (normal) and after a 15 min of LAD occlusion and subsequent 30 min-reperfusion (stunned). Percent segment shortening (%SS) and percent post-systolic shortening (%PSS) were evaluated. Myocardial extraction of oxygen (EO2) and lactate (Elac) was calculated. RESULTS: Amrinone or dobutamine in the normal myocardium caused dose-dependent increases in %SS that were comparable (range, 20~40%) but had no effect on %PSS. MVO2 increased in parallel with %SS for both amrinone and dobutamine. With amrinone, CBF increased more than MVO2, resulting in a modest decrease in EO2, whereas with dobutamine, CBF increased in proportion to MVO2, resulting in no change in EO2. After the ischemia and reperfusion, %SS and Elac were reduced, but similar %SS and CBF responses to both agents were observed, except that both agents caused progressive reductions of %PSS. CONCLUSIONS: These results indicate that both amrinone and dobutamine exert positive inotropic effects in normal and stunned canine myocardium. It is also indicated that amrinone causes direct coronary vasodilation, which is not affected by ischemia and reperfusion, while dobutamine has no direct effect on coronary vascular tone in either normal or stunned myocardium.

Hemodynamic and intrapulmonary shunt effects of dobutamine/adenosine triphosphate and dobutamine/sodium nitroprusside infusion: Gyoung Yub Rhee, Seung Gyun Oh, Kyung Yeon Yoo, Chan Jin Park; Korean J Crit Care Med. 1991;6(1):13-25.

1,459 View
16 Download

Abstract PDF: No abstract available.

First
Prev
Page of 1
Next
Last

Search