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Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Fluid therapy is an intervention widely used in clinical practice. However, its application is not without risks and requires a careful evaluation of patient’s tolerance and response to volume. The empirical practice of fluid resuscitation can be potentially lethal. The purpose of this review was to provide an overview of the physiological and therapeutic principles for the administration of intravenous fluids in critically ill patients, addressing special populations, such as surgical, septic, and trauma patients. Methods. A narrative review was carried out based on articles published in PUBMED, ScienceDirect, and LILACS between 2001 and 2023. MESH terms fluid therapy, crystalloid solutions, and colloids were employed. Results. A total of 371 articles were found, of which randomized clinical trials studies, narrative reviews, systematic reviews, and meta-analyses that analyzed the role of crystalloids and colloids were selected. Manuscripts published on dates outside the search range, which were considered relevant for the description of the pathophysiology and the rationale for the use of intravenous fluids, were included. Conclusion. Reflective resuscitation is based on a holistic understanding of physiology and individualization of fluid therapy. The liberal use of intravenous fluids has potential harmful effects and resuscitation strategies should be guided by individual dynamic and static measures, which provide a safe framework for fluid management. [ABSTRACT FROM AUTHOR]

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Veterinaria Brasilica is the property of Acta Veterinaria Brasilica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Cientifica de la Facultade de Veterinaria is the property of Universidad del Zulia, Facultad de Ciencias Veterinarias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Las soluciones intravenosas son empleadas en la práctica diaria en Medicina Veterinaria para tratamientos médicos como mantenimiento y/o reposición de fluidos y la administración de medicamentos, pero al ser reutilizadas por periodos largos de tiempo, el riesgo de contaminación bacteriana aumenta. El objetivo principal de esta investigación fue la evaluación de la tasa de contaminación de tres soluciones intravenosas cristaloides, durante un periodo mayor a 72 h en situaciones clínicas habituales del ambiente veterinario. Las soluciones fueron analizas a las 96; 120 y 144 h, se determinó que, a partir de las 96 h de utilización de las soluciones intravenosas, ya existe contaminación bacteriana hasta en un 100 % como es el caso de la dextrosa al 50 %, y una contaminación del 75 % a las 120 h de la solución de cloruro de sodio al 0,9 %, y hasta un 50 % de contaminación de la solución de lactato de Ringer a las 144 h. Se concluye que partir de las 96 h de manipular las soluciones intravenosas, ya existe la presencia de bacterias ambientales, sobre todo en las soluciones dextrosadas que son las más propensas a la contaminación, a pesar de aplicar las técnicas antisépticas adecuadas.

Introduction: The efficacy and safety of the Rapid Intravenous Rehydration (RIR) guidelines in children affected by dehydration secondary to acute gastroenteritis is supported by current scientific evidence, but there is also great variability in its use in clinical practice. Objective: To prepare a document with evidence-based recommendations about RIR in paediatric population. Methods: The project was developed based on GRADE methodology, according to the following work schedule: Working Group training; creation of a catalogue of questions about research and definition of “relevant outcomes”; score and selection criteria for each item; bibliographic review; scientific evidence evaluation and synthesis (GRADE); review, discussion and creation of recommendations. 10 clinical questions and 15 relevant outcomes were created (7 about efficacy and 8 about security). Results: 16 recommendations were set up, from which we can highlight as the main ones: 1) RIR is safe for children affected by mild-moderate dehydration secondary to acute gastroenteritis, unless expressly contraindicated or acute severe comorbidity (strong recommendation, moderate evidence). 2) Its use is recommended in this situation when oral rehydration has failed or due to contraindication (strong, high). 3) Isotonic fluids are recommended (strong, high), suggesting saline fluid as the first option (light, low), supplemented by glucose (2.5%) in those patients showing normoglycemia and ketosis (strong, moderate). 4) A rhythm of 20cc/kg/h is recommended (strong, high) during 1−4 h (strong, moderate). Conclusions: This document establishes consensus recommendations, based on the available scientific evidence, which could contribute to the standardisation of the use of RIR in our setting. Resumen: Introducción: Existe consenso en cuanto a la eficacia y seguridad de las pautas de rehidratación intravenosa rápida (RIR) en niños con deshidratación secundaria a gastroenteritis aguda (GEA), pero también una gran variabilidad en su uso en la práctica clínica. Objetivo: elaborar un documento de recomendaciones sobre la RIR en población pediátrica basadas en la evidencia científica. Metodología: Se diseñó un proyecto basado en metodología GRADE, siguiendo el siguiente esquema de trabajo: Formación del Grupo de Trabajo; formulación de preguntas de investigación y definición de “desenlaces de interés”; puntuación y selección de ítems; revisión bibliográfica; evaluación y síntesis de la evidencia (GRADE); revisión, discusión y formulación de recomendaciones. Se incluyeron 10 preguntas clínicas y 15 desenlaces de interés (7 de eficacia y 8 de seguridad). Resultados: Se establecieron 16 recomendaciones, destacando como principales: 1) La RIR es segura en niños con deshidratación leve-moderada secundaria a GEA, salvo contraindicación expresa o comorbilidad aguda grave (recomendación fuerte, evidencia moderada); 2)Se recomienda su uso en este contexto cuando la rehidratación oral haya fracasado o esté contraindicada (fuerte, alta); 3)Se recomienda utilizar sueros isotónicos (fuerte, alta), sugiriendo como primera opción el suero fisiológico (débil, baja), añadiendo glucosa (2,5%) en pacientes con glucemia normal y cetosis (fuerte, moderada). 4)Se recomienda un ritmo de infusión de 20 mL/kg/hora (fuerte, alta), durante una a cuatro horas (fuerte, moderada). Conclusiones: En este documento se establecen recomendaciones de consenso, basadas en la evidencia científica disponible, que podrían contribuir a homogeneizar el uso de la RIR en nuestro medio.

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Intravenous fluid therapy is one of the most common therapeutic prescriptions in hospitalized clinical patients with the aim of correcting or maintaining the water and electrolyte balance that guarantees adequate cardiac output, perfusion and tissue oxygenation to the different organs. During the last decades it has presented great and constant advances that make it necessary to review and analyze it frequently: in general, the four main indications for its administration are resuscitation, replacement, maintenance and fluid slippage. Prior to its administration, the indications, contraindications, volume, frequency and type of liquid to be administered must be known, analyzing above all the benefit-risk relationship and seeking to restore the enteral route as soon as possible. A non-systematic narrative review of the topic was carried out, searching for references in Elsevier, Pubmed, SciELO, Medline, Nature and New England Journal of Medicine published from 2010 to 2020 in English and Spanish. The progress obtained in intravenous fluid therapy is evident from its implementation in the replacement of water and electrolytes lost in diarrheal diseases to the concept of optimizing cardiac output, therapy guided by objectives and phases, becoming one of the most frequent indications in hospitalized clinical patients; its indication must be made in a conscientious way and according to the clinical situation of the patient, maintaining close monitoring through clinical measurements or the use of imaging studies, which allow determining their response, avoiding complications. [ABSTRACT FROM AUTHOR]

The administration of intravenous fluids is the most common intervention in hospitalised patients in the perioperative setting and critical care units. The aim of this narrative review is to provide an overview of balanced solutions for fluid therapy in the perioperative period in adult patients, and to review new trends and solutions in fluid therapy. The evidence was grouped into 3 areas: intraoperative fluid administration, fluid administration in critically ill patients, and the importance / benefit of balanced crystalloid solutions. Although a number of high-quality studies have been published in recent years, the scientific evidence regarding the type of fluid, the dose, and rate of administration is still limited. The choice of fluid therapy during the perioperative period must be tailored to patient-specific factors, the nature of the surgery, expected fluid loss, and other relevant factors. Finally, more robust clinical evidence and physician training is of the utmost importance., (Copyright © 2024 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Las soluciones intravenosas se utilizan en tratamientos médicos para reposición de fluidos y para la administración de medicamentos. En 1971 el CDC (Centro para el Control y Prevención de Enfermedades de Estados Unidos de América) estableció que las soluciones intravenosas se las debe utilizar en un período de 24 horas (h), y posterior a este tiempo se debe descartar, recomendación que no es seguida en todos los Centros. En la práctica diaria, en contra de las adecuadas normas sanitarias, dentro de los centros veterinarios locales es común la reutilización de fluidos por largos períodos de tiempo, para reconstitución de medicamentos inyectables, limpiezas de heridas o administración a otros pacientes. El objetivo principal del estudio fue evaluar la tasa de contaminación de bolsas de tres tipos de soluciones intravenosas (cloruro de sodio 0,9 %, lactato de Ringer y solución de dextrosa 50 %) durante un período de 72 h en condiciones clínicas de un entorno veterinario. Las soluciones se analizaron a las 0; 24; 48 y 72 h. No hubo crecimiento bacteriano en ninguna de las muestras obtenidas, los cultivos se reportaron como negativos tras 72 h de no observar desarrollo bacteriano en medios de cultivos estándar. Estudios después de este período de tiempo son necesarios para determinar si existe contaminación bacteriana tras las 72h.

RESUMEN Se presenta el caso de una paciente de 80 años, afectada de una gastroenteritis aguda de 2 semanas de evolución en posible relación con un cuadro viral. La causa principal es la infección transmitida por alimentos y superficies contaminadas, que en personas de edad avanzada supone un riesgo para su vida debido a la deshidratación. Por ello, será fundamental una reposición de líquidos oral e intravenosa, además de una introducción temprana de alimentación sólida. La valoración de las respuestas de la paciente se ha realizado a partir de los requisitos de autocuidado de Dorothea Orem. La evolución ha sido favorable, y en el periodo de una semana se redujeron las deposiciones en frecuencia y características favoreciendo así la restauración de la piel perianal, se sustituyó la fluidoterapia con reposición de electrolitos por hidratación oral, y la dieta astringente pasó a dieta basal, con buena tolerancia.

Introduction: Fluids administration constitutes one of the treatment pillars in patients admitted to Intensive Care Unit in which the inadequate reanimation and overload of volume worsen the prognosis. Objective: To characterize the state of fluid administration to patients admitted to the Intensive Cares Units of Dr. Antonio Luaces Iraola Teaching General Hospital in Ciego de Ávila and its relationship with mortality. Methods: An analytic and prospective descriptive study of 147 patients admitted to the Intensive Cares Units of Dr. Antonio Luaces Iraola Teaching General Hospital was carried out in Ciego de Ávila during the first semester of 2020, for which 598 tests of fluids, some hemodynamic variables and the balance of liquids were evaluated in the first 72 hours of admission. Results: The average age was 48.3 years, there was a prevalence of women (55.8 %), the punctuation of APACHE II at admission was 14.2 points and 22.4 % of those affected died. To administer fluids the clinical approach prevailed (57.2 %); while the central venous pressure, heart frequency, the mean arterial pressure and diuresis were similar in alive and dead patients. The accumulated balance of fluids was significantly higher in the group of dead patients (1984.70 mL vs 260 mL). Conclusions: The changes in the vital parameters after administering fluids were not useful to evaluate the response to the volume. The accumulated balance of fluids was related to mortality in a significant way. [ABSTRACT FROM AUTHOR]

Introduction: Fluids administration constitutes one of the treatment pillars in patients admitted to Intensive Care Unit in which the inadequate reanimation and overload of volume worsen the prognosis. Objective: To characterize the state of fluid administration to patients admitted to the Intensive Cares Units of Dr. Antonio Luaces Iraola Teaching General Hospital in Ciego de Ávila and its relationship with mortality. Methods: An analytic and prospective descriptive study of 147 patients admitted to the Intensive Cares Units of Dr. Antonio Luaces Iraola Teaching General Hospital was carried out in Ciego de Ávila during the first semester of 2020, for which 598 tests of fluids, some hemodynamic variables and the balance of liquids were evaluated in the first 72 hours of admission. Results: The average age was 48.3 years, there was a prevalence of women (55.8 %), the punctuation of APACHE II at admission was 14.2 points and 22.4 % of those affected died. To administer fluids the clinical approach prevailed (57.2 %); while the central venous pressure, heart frequency, the mean arterial pressure and diuresis were similar in alive and dead patients. The accumulated balance of fluids was significantly higher in the group of dead patients (1984.70 mL vs 260 mL). Conclusions: The changes in the vital parameters after administering fluids were not useful to evaluate the response to the volume. The accumulated balance of fluids was related to mortality in a significant way.

Copyright of Revista Cientifica de la Facultade de Veterinaria is the property of Universidad del Zulia, Facultad de Ciencias Veterinarias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Isotonic fluids, in most cases, are the safest way to dispense fluids intravenously. The aim of this study was to determine the prescription of maintenance intravenous fluids and to study possible associated factors. Material and method: A descriptive, cross-sectional, multi-centre study was performed. A questionnaire was sent nationwide to several healthcare providers via an online survey, sent by email through different Medical Scientific Societies, and the Official Spanish Medical Association, between December 2016 and December 2017. Results: A total of 487 questionnaires were received, of which 456 were submitted by paediatricians. More than one quarter (28.95%) (95% CI; 24.77–33.13) of the paediatricians usually dispense hypotonic fluids and 81.14% (95% CI; 77.54–84.74) prescribe infusion rates based on the Holliday and Segar protocol. The general profile of paediatricians who prescribe hypotonic fluids intravenously in Spain are medical residents, paediatricians working in paediatric non-intensive care units, in private hospitals, and those who recognise that no consensus exists among their direct work colleagues regarding this subject. Conclusions: More than twenty-five per cent of all paediatricians in our country continue to use hypotonic fluids as maintenance intravenous fluid therapy. There might be several potential factors associated to this. These kind of studies provide evidence of the great difficulties in transferring scientific knowledge to clinical practice. Resumen: Introducción: Los fluidos isotónicos, en la mayoría de los casos, constituyen la forma más segura de administración de líquidos por vía intravenosa. Los objetivos de nuestro trabajo han sido describir las prácticas de prescripción de los fluidos intravenosos de mantenimiento y estudiar los posibles factores asociados. Material y método: Estudio transversal, descriptivo, multicéntrico de ámbito nacional, mediante encuesta on-line, difundida a través de sociedades científicas médicas y la Organización Médica Colegial, entre diciembre de 2016 y diciembre de 2017. Resultados: Un total de 487 encuestas fueron recibidas, 456 de pediatras. El 28,95% (IC 95%: 24,77-33,13) de ellos prescribían habitualmente fluidos hipotónicos y el 81,14% (IC 95%: 77,54-84,74) se basaba en la regla de Holliday y Segar para calcular el volumen total a infundir. El perfil del pediatra en España que utiliza fluidos hipotónicos intravenosos es el de médico residente de pediatría, pediatra que trabaja en áreas diferentes a las unidades de cuidados intensivos pediátricos, en hospitales privados, y aquellos que reconocen que no existe un consenso al respecto en su grupo de trabajo. Conclusiones: Más de una cuarta parte de los pediatras en nuestro país sigue utilizando los fluidos hipotónicos como fluidoterapia intravenosa de mantenimiento. Diferentes factores podrían estar asociados a este hecho. Estos estudios son prueba de las grandes dificultades existentes para trasladar el conocimiento a la práctica.

La fluidoterapia es un pilar del tratamiento del shock séptico, el acúmulo de un balance hídrico ? al 10% del peso se asocia con malos resultados hospitalarios. Objetivo: el presente estudio pretende determinar el Índice de Sobrecarga Hídrica (ISCH>10%) en pacientes con shock séptico, y sus principales asociaciones en función de mortalidad y morbilidad. Métodos: se realizó un estudio de tipo observacional y descriptivo, en 49 niños internados con shock séptico en la UTIP del HNMAV; se dividieron los pacientes en dos grupos según el ISCH > al 10% (22 pacientes) y 10% una media de 5681ml; mientras en el grupo con ISCH 10% (disfunción respiratoria, requerimiento de vasopresores y terapia de remplazo renal). Los días de hospitalización y en UTIP no fueron diferentes en los grupos (p=0.6), pero hubo mayor mortalidad de pacientes con ISCH >10% (p=0.01; OR:5,57 IC95% 1,4-21,8). Conclusiones: la administración de líquidos en el paciente con shock séptico constituye uno de los tratamientos hemodinámicos de primera línea, sin embargo, en establecimientos de recursos limitados se debe evitar la sobrecarga, principalmente por las morbilidades asociadas las primeras 72 horas.

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Medicina do Esporte is the property of Redprint Editora Ltda. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Transplante renal é o tratamento padrão‐ouro na doença renal em estágio terminal. Embora diferentes variáveis hemodinâmicas, tais como pressão venosa central e pressão arterial média, têm sido usadas para orientar a estratégia de reposição volêmica durante a cirurgia, a melhor estratégia ainda não foi determinada. A Variação da Pressão de Pulso (VPP) durante o ciclo respiratório é reconhecida como um bom preditor da resposta à infusão de volume para otimização hemodinâmica perioperatória no centro cirúrgico. O objetivo do estudo foi estudar se a estratégia de reposição de volume orientada por VPP é melhor do que a estratégia liberal de reposição de volume durante cirurgia de transplante renal. O principal objetivo do estudo foi identificar diferença no débito urinário na primeira hora do pós‐operatório. Realizamos estudo prospectivo, unicego, randomizado, controlado. Incluímos 40 pacientes submetidos a transplante renal de doador cadáver. Pacientes randomizados para o Grupo VPP receberam volume quando a VPP estava acima de 12%, e os pacientes no Grupo Reposição Liberal receberam volume de acordo com o nosso protocolo institucional padrão de assistência para transplante renal (10 mL.kg‐1.h‐1). O débito urinário foi semelhante em todos os tempos nos dois grupos, a ureia foi estatisticamente diferente a partir do terceiro dia do pós‐operatório com pico no quarto dia do pós‐operatório e a creatinina apresentou tendência semelhante, tornando‐se estatisticamente diferente a partir do segundo dia do pós‐operatório. Ureia, creatinina e débito urinário não estavam diferentes na alta hospitalar. A terapia orientada por VPP durante transplante renal melhorou de forma significativa os níveis de ureia e creatinina na primeira semana pós‐transplante renal. Kidney transplantation is the gold‐standard treatment for end stage renal disease. Although different hemodynamic variables, like central venous pressure and mean arterial pressure, have been used to guide volume replacement during surgery, the best strategy still ought to be determined. Respiratory arterial Pulse Pressure Variation (PPV) is recognized to be a good predictor of fluid responsiveness for perioperative hemodynamic optimization in operating room settings. The aim of this study was to investigate whether a PPV‐guided fluid management strategy is better than a liberal fluid strategy during kidney transplantation surgeries. Identification of differences in urine output in the first postoperative hour was the main objective of this study. We conducted a prospective, single blind, randomized controlled trial. We enrolled 40 patients who underwent kidney transplantation from deceased donors. Patients randomized in the PPV Group received fluids whenever PPV was higher than 12%, patients in the Free Fluid Group received fluids following our institutional standard care protocol for kidney transplantations (10 mL.kg‐1.h‐1). Urinary output was similar at every time‐point between the two groups, urea was statistically different from the third postoperative day with a peak at the fourth postoperative day and creatinine showed a similar trend, being statistically different from the second postoperative day. Urea, creatinine and urine output were not different at the hospital discharge. PPV‐guided fluid therapy during kidney transplantation significantly improves urea and creatinine levels in the first week after kidney transplantation surgery. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate in bovines, the average comparison of the infusion speed of two isotonic solutions of commercial brands (NaCl Solution 0.9% and Ringer Solution with lactate), through the intraperitoneal infusion technique. The experiment was conducted at the PlanFelix site in the city of Assaí - PR. The activities of the experiment were performed on a single day in March 2018, with five repetitions, being selected ten cows, randomly drawn and divided into two experimental groups, where those with even numbers were evaluated in the morning and those with odd numbers in the afternoon. Through intraperitoneal infusion, one group received three liters of 0.9% NaCl solution, and the other received three liters of Ringer Lactate. The statistical design was entirely randomized. The models were analyzed using Rstudio software (version 3.0.3), with a significance level of 0.05. All variables found were submitted to descriptive and variance analysis and the means of treatment were compared in Tukey's test. It was concluded that the mean intraperitoneal infusion speed for 3 liters of 0.9% NaCl solution and lactate Ringer in the experiment did not have significant difference between the treatments; the mean time proved efficient for application in cattle in the field; these fluids can be safely administered under these conditions and by the evaluated technique, because no adverse reactions and post-treatment changes were found. [ABSTRACT FROM AUTHOR]

Sin resumen

Introduction: septic shock is a common cause of death in children worldwide, it is the first cause of admission to the units of non-coronary intensive care and it is an emerging disease. Objective: to describe the results of therapy with fluid in patients with septic shock at “José Luis Miranda” Hospital in one year of study. Method: a descriptive, longitudinal, prospective study between January and December 2012 with patients admitted to the Intensive Care Unit of the hospital was realized. Data were recorded in the statistical professional program SPSS version 15.0, the information was showed in tables and graphs and inferential statistics tests were applied. Results: the most affected age group was that of one month to one year, of male sex; severe acute respiratory infections were the most frequent etiologies; the administration of intravenous fluids contributed to the recovery of clinical parameters related to perfusion at six hours; with the administration of 60ml/kg of intravenous fluids there was a recovery of blood pressure in most children. Conclusions: aggressive and early administration of intravenous fluids contributes to the recovery of clinical parameters related to perfusion at six hours and reducing mortality in children with septic shock.

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fluid therapy is the first maneuver performed by the physician to be in contact with a patient who is intended to increase the volemia, the administration of parenteral solution type, the amount and duration in its application is the challenge of the intensivist. Currently the hemodynamic monitoring has undergone an important technological advance, being minimally invasive and with not only static but also dynamic constants, they have allowed to improve the medical decision making in the critically ill patient. The present non-systematic review aims to provide an update on measurements that are considered new tools before old paradigms in hemodynamic monitoring. [ABSTRACT FROM AUTHOR]

Currently burns represent a public health problem due to their high prevalence mainly in developing countries. These events have different consequences for the affected individual, regardless of burn extent, an accurate evaluation and a therapeutic approaches of any patient in a critical condition is necessary. The burns classification being fundamental to adjust the treatment to its characteristics. Therefore, the health professional trained in acute care must know the steps of the initial care of burns and understand that within the resuscitation, fluid therapy is the main component and its proper administration will restore and preserve the vital function of the organs. Throughout the years, different classifications and formulas have been used for corporal surface calculation in order to carry out an adequate infusion of liquids, nevertheless the subjectivity in its determination often generate errors in the handling, for which reason it is necessary to know the latest findings regarding the most objective assessment of the burned patient. [ABSTRACT FROM AUTHOR]

Fluid therapy is one pillar of the treatment of septic shock, however, a hydric = 10% of the weight or Index of Water Overload (ISCH> 10%) is associated with poor hospital outcomes. Objective: the present study aims to determine the ISCH in patients with septic shock, and its main associations in terms of mortality and morbidity. Methods: an observational and descriptive study was conducted in 49 children hospitalized with septic shock in the UTIP of the HNMAV; The patients were divided into two groups according to the ISCH> 10% (22 patients) and <10% (18 patients), for their descriptive analysis we included comparison of means and calculation of the OR. Results: regarding the water requirements we observed that the group with ISCH> 10% a mean of 5681ml; while in the group with ISCH <10% the mean was 3297.8ml (p= 0.19), showing greater overload with the administration of colloids and blood products (p = 0.02, p = 0.004). Regarding hospital outcomes, was found morbidity associated with ISCH > 10% (respiratory dysfunction, vasopressor requirement and renal replacement therapy); The length of hospitalization and UTIP were not different in groups (p = 0.6), but there was higher mortality of patients with SSI> 10% (p = 0.01, OR: 5.57 IC95% 1.4-21.8). Conclusions: fluids therapy of in the patient with septic shock constitutes one of the first-line hemodynamic treatments, however in limited resources settings, overload should be avoided, mainly due to associated morbidity during the first 72 hours. [ABSTRACT FROM AUTHOR]

O objetivo deste estudo foi avaliar os efeitos de diferentes taxas de infusão de fluidoterapia sobre parâmetros hematológicos e urinários em cães. Foram utilizados 30 cães, sem raça definida, machos, distribuídos em três grupos que receberam fluidoterapia (NaCl 0,9%) pelo período de uma hora nas taxas: G5 (5mL/kg); G10 (10mL/ kg); G50 (50mL/kg). Amostras de sangue para realização de hemograma, e de urina para realização de densidade urinária foram colhidas ao longo de diferentes momentos, assim como a avaliação do volume urinário produzido. Os valores do eritrograma foram menores estatisticamente de T10 a T240 em G10 e G50, em relação a T0. Na comparação entre grupos, os menores valores para o eritrograma foram encontrados em G50. A densidade urinária apresentou diminuição estatística entre momentos somente em G50, sendo que este grupo apresentou valores menores em relação a G5 e G10. O débito urinário apresentou diferenças estatísticas entre grupos, com maiores valores em G50 em praticamente todos os momentos estudados. Assim, pode-se concluir que a fluidoterapia altera os valores hematológicos em taxas de 10 e 50mL/ kg/h, se devendo esperar um período superior a quatro horas após o término da infusão para coleta de amostras de sangue. Ainda, a fluidoterapia altera a densidade urinária apenas em altas taxas de infusão (50mL/kg por 1 hora), sendo que, nesses casos, amostras de urina devem ser colhidas num período superior a 4 horas após o término da infusão, porém taxas mais baixas (5 e 10mL/Kg por 1 hora) não interferem com a densidade urinária.

INTRODUCCIÓN: Múltiples soluciones de reemplazo se utilizan en el tratamiento del shock hipovolémico, sepsis severa, shock séptico y medicina perioperatoria, la selección de cual usar ha estado gobernada por variables como disponibilidad, costo y tradición. En los últimos años una nueva consideración ha marcado el interés de la comunidad médica, los efectos sistémicos de los diferentes preparados y la repercusión de estos en la recuperación final. OBJETIVOS: Realizar una puesta al día sobre la fluidoterapia con coloides en el shock hipovolémico. MATERIAL Y MÉTODO: Se consultó amplia y actualizada bibliografía nacional e internacional mediante la red nacional de información médica y sus importantes enlaces. DESARROLLO: Se realizó una revisión de la literatura sobre el tema, en el cual se abordó la problemática de la fluidoterapia con coloides en el shock hipovolémico, sus consideraciones y particularidades. CONCLUSIONES: Desafortunadamente cuando se revisa este tema se encuentran limitaciones relacionadas con el tamaño de la muestra o el diseño utilizado en los diferentes estudios lo que limita el arribo a conclusiones definitivas y por ende la propuesta de guías terapéuticas

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ABSTRACTSevere sepsis and septic shock represent a major healthcare challenge. Much of the improvement in mortality associated with septic shock is related to early recognition combined with timely fluid resuscitation and adequate antibiotics administration. The main goals of septic shock resuscitation include intravascular replenishment, maintenance of adequate perfusion pressure and oxygen delivery to tissues. To achieve those goals, fluid responsiveness evaluation and complementary interventions - i.e. vasopressors, inotropes and blood transfusion - may be necessary. This article is a literature review of the available evidence on the initial hemodynamic support of the septic shock patients presenting to the emergency room or to the intensive care unit and the main interventions available to reach those targets, focusing on fluid and vasopressor therapy, blood transfusion and inotrope administration.

INTRODUCTION: Several clinical trials on Goal directed fluid therapy (GDFT) were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to renal failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids in GDFT to determine associated complications and mortality.METHODS: A bibliographic research was carried out in MEDLINE PubMed, EMBASE and Cochrane Library, corroborating randomized clinical trials where crystalloids are compared to colloids in GDFT for major non-cardiac surgery in adults.RESULTS: One hundred thirty references were found and among those 38 were selected and 29 analyzed; of these, six were included for systematic review and meta-analysis, including 390 patients. It was observed that the use of colloids is not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% CI] 3.87 [1.121-13.38]; I2 = 0.0%; p = 0.635).CONCLUSIONS: Because of the limitations of this meta-analysis due to the small number of randomized clinical trials and patients included, the results should be taken cautiously, and the performance of new randomized clinical trials is proposed, with enough statistical power, comparing balanced and unbalanced colloids to balanced and unbalanced crystalloids, following the protocols of GDFT, considering current guidelines and suggestions made by groups of experts.

In an effort to standardize perioperative management and improve postoperative outcomes of adult patients undergoing surgery, the Ministry of Health, through the Spanish Multimodal Rehabilitation Group (GERM), and the Aragonese Institute of Health Sciences, in collaboration with multiple Spanish scientific societies and based on the available evidence, published in 2021 the Spanish Intensified Adult Recovery (RICA) guideline. This document includes 12 perioperative measures related to fluid therapy and hemodynamic monitoring. Fluid administration and hemodynamic monitoring are not straightforward but are directly related to postoperative patient outcomes. The Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR) has reviewed these recommendations and concluded that they should be revised as they do not follow an adequate methodology., (Copyright © 2023 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: The population of Latin America harbors the highest incidence of gallstones and acute biliary pancreatitis, yet little is known about the initial management of acute pancreatitis in this large geographic region., Participants and Methods: We performed a post hoc analysis of responses from physicians based in Latin America to the international multidisciplinary survey on the initial management of acute pancreatitis. The questionnaire asked about management of patients during the first 72h after admission, related to fluid therapy, prescription of prophylactic antibiotics, feeding and nutrition, and timing of cholecystectomy. Adherence to clinical guidelines in this region was compared with the rest of the world., Results: The survey was completed by 358 participants from 19 Latin American countries (median age, 39 years [33-47]; women, 27.1%). The proportion of participants in Latin America vs. the rest of the world who chose non-compliant options with clinical guidelines were: prescription of fluid therapy rate other than moderate (42.2% vs 34.3%, P=.02); prescription of prophylactic antibiotics for severe (10.6% vs 18.0%, P=.002), necrotizing (28.5% vs 36.9%, P=.008), or systemic inflammatory response syndrome-associated (21.2% vs 30.6%, P=.002) acute pancreatitis; not starting an oral diet to patients with oral tolerance (77.9% vs 71.1%, P=.02); and delayed cholecystectomy (16.2% vs 33.8%, P<.001)., Conclusions: Surveyed physicians in Latin America are less likely to prescribe antibiotics and to delay cholecystectomy when managing patients in the initial phase of acute pancreatitis compared to physicians in the rest of the world. Feeding and nutrition appear to require the greatest improvement., (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)

Introduction: Adrogué -- Madias´ formula is widely used in hyponatremia to estimate the sodium achieved by fluid therapy, but no studies have been done to see its usefulness in burned patients. Objective: Determine the utility of the Adrogué -- Madias´ formula in the estimation of sodium achieved after fluid therapy in burned patients. Material and method: Descriptive cohort study. Population: patients aged <14 years with burns> 10% of BSA, and patients> 14 years with BSA> 15%, who arrive in the first 24 hours of the burn. The infusion volume was calculated according to SCQ. Arterial blood gas analysis was taken on admission and completed the first 24 hours to compare the sodium. Finally, the calculated sodium with the Adrogué -- Madias´ formula and the real sodium at 24 hours were compared. Results: population: 24 patients. 79.2% of the population had hyponatremia. Student's t-test for related samples compared the sodium obtained by Adrogué-Madias´ formula and the sodium at 24 hours, obtaining a value of t = 7.893 (95% IC, p = 0.000189). The Pearson correlation coefficient did not show statistical significance when relating the clinical characteristics with the difference between the sodium obtained by the Adrogué -- Madias´ formula and the sodium at 24 hours. Conclusion: the Adrogué -- Madias´ formula is not useful in the determination of sodium after fluid therapy in burned patients. [ABSTRACT FROM AUTHOR]

Objective. Diarrhea remains a leading cause of morbidity and mortality for children in low- and middle-income countries throughout the Americas. The World Health Organization (WHO) has developed guidelines on incorporating zinc supplementation (ZS) with traditional oral rehydration therapy (ORT) in order to shorten the duration of diarrheal episodes and to reduce poor health outcomes. Guatemala adopted these guidelines in 2011, but they have not yet been fully implemented at the community level. The objectives of this study were: (1) to co-design an ORT/ZS training program for community members with local health promoters that is appropriate to the local context and (2) to understand how attitudes and behaviors of community members changed after receiving training from the study promoters. Methods. In an observational study, community health promoters in rural Guatemala were trained according to WHO guidelines, and they worked collaboratively with the study team to develop a training curriculum to implement in their community. Community-based surveys, interviews, and focus group discussions were used to assess acceptability, accessibility, and availability of oral rehydration therapy and zinc supplementation. Results. Use of ORT increased from 63% to 95% among community members following training by local health promoters. Satisfaction with the service offered by health promoters increased from 63% to 90% amongst community members trained by the study promoters. However, knowledge and use of zinc supplementation remained low, which was attributable to unavailability of zinc in the study community. Conclusions. Use of trained community health promoters is an effective way to translate WHO guidelines to local contexts and overcome sociocultural barriers to care. However, the health system's structure must support availability of essential medicines in order to effectively implement those guidelines. [ABSTRACT FROM AUTHOR]

Introducción: dos factores importantes han sido descritos como contribuyentes en la aparición de fatiga durante el ejercicio físico: la disminución de las reservas de glucógeno muscular y la pérdida de agua con electrolitos a través del sudor, que favorecen la deshidratación. Debido a esto, la reposición de líquidos y electrolitos posterior al ejercicio físico se transforma en la prioridad para restablecer la homeostasis corporal alterada durante el ejercicio físico. Por su composición nutricional, la leche parece ser una buena alternativa natural como bebida rehidratante posterior al ejercicio físico. Objetivo: comparar la efectividad como bebida de rehidratación de la leche descremada chocolatada contra una bebida deportiva artificial en militares, a partir de la hipótesis de que la leche descremada chocolatada tiene iguales o mejores efectos sobre la hidratación post ejercicio, que una bebida deportiva artificial. Método: 30 militares (23,0 ± 3,2 años) se dividieron en 2 grupos: 1) rehidratación con bebida deportiva con 6 % de carbohidratos y relación de Na/K 2:1 (grupo ISO). Rehidratación con leche descremada chocolatada (grupo LECHE). Se evaluó la retención de fluidos a través del peso corporal y la gravedad específica de la orina (GEO) antes y después del ejercicio físico y posterior a las 2 horas de rehidratación. Resultados: se encontraron diferencias significativas (p< 0,05) en la retención de fluidos en el grupo LECHE comparado con el grupo ISO. No hubo diferencias significativas entre la GEO de ambos grupos. Conclusión: Los resultados muestran que la rehidratación con leche descremada es más efectiva en la retención de fluidos y recuperación del peso previo al ejercicio que la bebida deportiva.

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Resumo Introdução O jejum no pré‐operatório é há muito tempo considerado uma importante causa de depleção de líquidos, leva a instabilidade hemodinâmica durante a cirurgia, caso a reposição não seja prontamente instituída. Recentemente, esse ponto de vista tradicional tem sido progressivamente desafiado e um número crescente de autores agora propõe uma abordagem mais restritiva para o controle de líquidos, embora permaneçam dúvidas quanto à verdadeira influência hemodinâmica do jejum no pré‐operatório. Métodos Estudo observacional, analítico, prospectivo e longitudinal, no qual 31 voluntários ASA I e II foram submetidos a exame ecocardiográfico antes e após um período de jejum de no mínimo seis horas. Os dados dos índices de pré‐carga tanto estáticos quanto dinâmicos foram obtidos em ambos os períodos e subsequentemente comparados. Resultados Os índices estáticos de pré‐carga mostraram um comportamento acentuadamente variável com o jejum. Os índices dinâmicos, entretanto, foram bem mais consistentes entre si, todos apontam na mesma direção; isto é, não evidenciam alteração estatisticamente significativa com o período de jejum. Analisamos também a confiabilidade dos índices dinâmicos para responder a alterações pré‐carga intencionais conhecidas. A variação da integral de velocidade-temo (VTI) aórtica com a manobra de elevação passiva dos membros inferiores foi a única variável que mostrou sensibilidade suficiente para sinalizar de forma consistente a presença de variação na pré‐carga. Conclusão O jejum não pareceu causar uma alteração na pré‐carga de voluntários conscientes nem alterou substancialmente a sua posição na curva de Frank‐Starling, mesmo com tempos de jejum mais prolongados do que o normalmente recomendado. A variação do VTI transaórtico com a manobra de elevação passiva dos membros inferiores foi o índice dinâmico mais consistente (dos estudados) para avaliar a capacidade de resposta a variações da pré‐carga em pacientes que respiram espontaneamente. Introduction Preoperative fasting was long regarded as an important cause of fluid depletion, leading to hemodynamic instability during surgery should replenishment not be promptly instituted. Lately, this traditional point of view has been progressively challenged, and a growing number of authors now propose a more restrictive approach to fluid management, although doubt remains as to the true hemodynamic influence of preoperative fasting. Methods We designed an observational, analytic, prospective, longitudinal study in which 31 ASA 1 and ASA 2 volunteers underwent an echocardiographic examination both before and after a fasting period of at least 6 h. Data from both static and dynamic preload indices were obtained on both periods, and subsequently compared. Results Static preload indices exhibited a markedly variable behaviour with fasting. Dynamic indices, however, were far more consistent with one another, all pointing in the same direction, i.e., evidencing no statistically significant change with the fasting period. We also analysed the reliability of dynamic indices to respond to known, intentional preload changes. Aortic velocity time integral (VTI) variation with the passive leg raise manoeuvre was the only variable that proved to be sensitive enough to consistently signal the presence of preload variation. Conclusion Fasting does not appear to cause a change in preload of conscious volunteers nor does it significantly alter their position in the Frank–Starling curve, even with longer fasting times than usually recommended. Transaortic VTI variation with the passive leg raise manoeuvre is the most robust dynamic index (of those studied) to evaluate preload responsiveness in spontaneously breathing patients. [ABSTRACT FROM AUTHOR]