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With persistent advancement of surgical instruments, methods and techniques, clinical efficacy of liver transplantation has been steadily enhanced. However, the length of anhepatic phase is still an important factor affecting the efficacy of liver transplantation. Rat is one of the major animal models for liver transplantation-related basic research. In this article, multiple approaches for prolonging the anhepatic phase and shortening the operation time during anhepatic phase in rat liver transplantation were reviewed, which consisted of sevoflurane inhalation anesthesia, intravenous infusion via jugular vein indwelling needle, clamping of the abdominal aorta before anhepatic phase, injection of normal saline into portal vein before anhepatic phase, subcutaneous transposition of the spleen, electrocoagulation of hepatic esophageal artery, magnetic ring anastomosis of the superior and inferior hepatic vena cava, cannula anastomosis of the superior and inferior hepatic vena cava, stent anastomosis of the superior and inferior hepatic vena cava, rapid connection device and cannula of portal vein, and ring-shaped cannula of hepatic tissue-preserving inferior hepatic vena cava, aiming to add evidence for prolonging the duration of anhepatic phase, improving the operation efficiency during anhepatic phase and elevating the success rate of rat liver transplantation.
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Objective: To investigate the effect of acute hypervolemic fluid infusion (AHFI) during induction of general anesthesia on intraoperative hemodynamic fluctuation in the patients undergoing pancreatic robotic surgery. Methods: Sixty patients undergoing Da Vinci robot-assisted pancreatic surgery were randomly divided into routine infusion group (control group, n=30) and AHFI group (n=30). In AHFI group, the patients were infused with 12.5 mL/kg crystalloid solution before anesthesia induction, 12.5 mL/kg colloidal solution before pneumoperitoneum, and 8 mL/(kg•h) (crystalloid solution:colloidal solution=1:1) continuously after pneumoperitoneum. The patients in control group were treated with routine liquid therapy. The mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), cardiac index (CI), stroke volume variation (SVV), and the incidence of adverse events in both groups were recorded. After operation, the exhaust time, hospitalization time and 3-month mortality of the two groups were followed up. Results: Compared with control group, the consumption of crystalloid solution, colloidal solution and both solutions in AHFI group increased (P0.05). Compared with control group, CVP increased significantly and SVV decreased significantly in AHFI group before pneumoperitoneum, after pneumoperitoneum and after postural changes (P0.05). Conclusion: Compared with conventional fluid infusion, AHFI during anesthesia induction can reduce the occurrence of adverse events in the patients undergoing Da Vinci robot-assisted pancreatic surgery. There is no significant difference in the recovery of gastrointestinal function and prognosis between the two methods.
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Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases(group A) had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases (group B) had the total burn area of >50% TBSA or Ⅲ degree >20% TBSA for group B and 10 cases(group C) had the total burn area>90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A (P<0 .05) .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .
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@#Objective To investigate the effect of different speed of perioperative fluid infusion on rate of platelet aggregation during percutaneous coronary intervention. Methods 60 patients accepted percutaneous coronary intervention (PCI) were divided into 2 groups. The control group (n=30) accepted fluid infusion in speed of 1.5~2 ml/kg·h, while the trial group (n=30) with the speed of 6~9 ml//kg·h after coronary arteriongraphy. Their blood pressure, heart beat, rate of platelet aggregation and osmotic pressure of plasma were recorded. Results It was not significantly different in rate of platelet aggregation before and 4 h after operation in the control group (P>0.05), and it was significantly lower 4 h and 1 d after operation in the trial group (P<0.05). Conclusion Fast fluid infusion perioperatively can lower the rate of platelet aggregation, which may improve the success of PCI and reduce the acute thrombosis
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Objective To evaluate whether PiCCO(pulse indicator continuous cardiac output) technique using for monitoring and guiding fluid infusion is a valuable tool in patients with mechanical ventilation. Methods Eighteen consecutive mechanically ventilated patients were installed PiCCO catheter and CVP catheter. All data from PiCCO technique were recorded and analyzed prospectively. Meanwhile, all data from PiCCO technique were compared with data from CVP. Results During the period of five-day monitoring, GEDV and ITBV were always higher than normal value and remained unchanged significantly.EVLWI was also higher significantly than normal value but decreased not significantly during the period of five-day monitoring. CI was normal and remained unchanged basically. GEDV and ITBV were significantly correlated with EVLWI and CI, but not CVP. Conclusions Volume variables(GEDV,ITBV)from PiCCO technique are more useful indicators than pressure variables (CVP)for assessment and guidance of fluid infusion.
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Objective The management of fluid infusion is crucial in severe sepsis/septic shock patients.The correlation of extravascular lung water index(EVLWI) versus oxygenation index ( PaO2/FiO2 ) and EVLWI versus intrathoracic blood volume index(ITBVI) were analysed in this present study. Method Totally 24 patients,admitted to the Intensive Care Unit of Second Affiliated Hospital of Zhejiang University, College of Medicine and diagnosed as severe sepsis/septic shock with acute lung injury and/or acute respiratory distress syndrome,were enrolled. ITBVI and EVLWI were detected with PiCCO technique. Correlation of EVLWI and PaO2/FiO2, ITBVI and EVLWI were analysed,respectively. Simple correlation and simple linear regression were used for statistical analysis. Results Significant negative correlation was found of EVLWI and PaO2/FiO2 ( r = - 0. 45, P ＜ 0.01).EVLWT = 14 mL/kg was defined as the cutoff value for the subgroup analysis. No correlation was found between EVLWI and PaO2/FiO2 in the subgroup with EVLWI≤ 14 mL/kg ( r = 0. 12, P = 0.243), but in the subgroup with EVLWI ＞ 14 mL/kg, significant negative correlation was found ( r = - 0. 47, P ＜ 0. 01 ). When EVLWI was higher than 14 mL/kg,EVLW should be decreased to improve oxygenation and other aspects should be taken into account. No significant correlation was found between ITBVI and EVLWI. A ITBVI value 1000 mL/m2 was also defined as the cutoff value for the subgroup analysis. No significant correlation was found in the subgroup with ITBVI≤ 1000 mL/m2( r = 0.13, P = 0.17), while significant positive correlation was found in the subgroup with ITBVI ＞ 1000 mL/m2. This result suggested that in patients of severe sepsis/septic shock with ALI/ARDS, when the blood volume is high, ITBV should be decreased to improve the oxygenation,however,it is not useful in the situation of high pulmonary vascular permeability. Conclusions Extravascular lung water has a important role in the fluid management in patients of severe sepsis/septic shock with ALI/ARDS.
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The present study the main physiological function of body fluid,the change of body fluid and the method of fluid infusion in exercising .It is practical to direct exercise of health and exercise training.
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OBJECTIVE:To study the adsorption of disposable transfusion connective tube and infusion needle for single use only to nitroglycerin in intravenous injection via minipump.METHODS:The intravenous injection via minipump was im-itated;the concentration change of nitroglycerin during the injection process was determined by the high performance liquid chromatography(HPLC)and ultraviolet spectrophotometry.RESULTS:Disposable transfusion connective tube and infusion needle for single use only had significant adsorption to nitroglycerin with an mean adsorption rate at(73.88?2.05)%within8hours.CONCLUSION:It is unsuitable to use those disposable transfusion connective tubes and infusion needles for single use only that have strong adsorption to nitroglycerin in the intravenous injection of nitroglycerin via minipump.
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How to use intravenous fluid therapy safely in patients with combined burn-blast injuries is an unsolved problem. Therefore, this experimental study was carried out in 64 dogs with combined injuries of 40% second degree burns (inflicted with nalpam) and moderate or severe blast injury (inflicted with TNT charge explosion) . Intravenous infusion was administered as early as 6-8 hours after injury. The amount was 0.5 ml colloid and 1-1.5 ml crystal solution/kg of body weight/one percent of body surface burns in the first 24 hours after injury, and a half of this amount was given in the second 24 hours. The transfusion of the fluid was finished within 3-5 hours. Another amount 30% of the total amount of the fluid intravenously infused was added as drinking water.It was found that there was no significant difference between the infused animals and the controls so far as the pulmonary pathological changes (including pulmonary edema) were concerned. It is believed that a reasonable amount of intravenous fluid can be safely given to patients with combined burn-blast injuries provided that the changes of the urinary output and the physical signs of the chest are carefully monitored.