Comparison of half-molar sodium lactate and mannitol to treat brain edema in severe traumatic brain injury: A systematic review / 中华创伤杂志(英文版)

PURPOSE@#Hypertonic fluids such as mannitol and half-molar sodium lactate are given to treat intracranial hypertension in patients with severe traumatic brain injury (TBI). In this study, sodium lactate was compared to mannitol in patients with TBI to investigate the efficacy in reducing intracranial pressure (ICP).@*METHODS@#This study was a systematic review with literature research on articles published in any year in the databases of PubMed, ScienceDirect, Asian Journal of Neurosurgery, and Cochrane Central Register of Controlled Trials. The keywords were "half-molar sodium lactate", "mannitol", "cerebral edema or brain swelling", and "severe traumatic brain injury". The inclusion criteria were (1) studies published in English, (2) randomized control trials or retrospective/prospective studies on TBI patients, and (3) therapies including half-molar sodium lactate and mannitol and (4) sufficient data such as mean difference (MD) and risk ratio (RR). Data analysis was conducted using Review Manager 5.3.@*RESULTS@#From 1499 studies, a total of 8 studies were eligible. Mannitol group reduced ICP of 0.65 times (MD 0.65; p = 0.64) and improved cerebral perfusion pressure of 0.61 times (MD 0.61; p = 0.88), better than the half-molar group of sodium lactate. But the half-molar group of sodium lactate maintained the mean arterial pressure level of 0.86 times, better than the mannitol group (MD 0.86; p = 0.09).@*CONCLUSION@#Half-molar sodium lactate is as effective as mannitol in reducing ICP in the early phase of brain injury, superior over mannitol in an extended period. It is able to prevent intracranial hypertension and give better brain tissue perfusion as well as more stable hemodynamics. Blood osmolarity is a concern as it increases serum sodium.

Significación del lactato sérico como biomarcador de infección del neonato intervenido quirúrgicamente / Significance of serum lactate as a biomarker of infection of the newborn undergoing surgery

Introducción: El neonato que se interviene quirúrgicamente está expuesto al desarrollo de infecciones. El lactato sérico ha sido recomendado como criterio diagnóstico de sepsis. Objetivo: Determinar la magnitud de asociación del valor del lactato sérico con la sepsis en el neonato intervenido quirúrgicamente. Métodos: Estudio entre 2013 y 2016, en el Hospital Pediátrico Universitario William Soler, en 307 neonatos intervenidos quirúrgicamente. Las variables se agruparon en: clínicas (edad gestacional, peso al nacer, causa de la intervención quirúrgica, localización de la infección) y paraclínicas (microorganismo causal, lactato sérico). Se aplicó la prueba de correlación lineal de Pearson parcial y se estimó odds ratio con el control de la variable infección (sí y no) para identificar la correlación entre los valores de lactato sérico en el preoperatorio y en el posoperatorio. Resultados: De los neonatos 63 tenían bajo peso (20,52 por ciento) y 55 eran pretérminos (17,92 por ciento). En los neonatos infectados 20,83 por ciento fueron operados por afecciones digestivas (n= 35); las infecciones sistémicas alcanzaron 67,74 por ciento (n= 42), ocasionadas en 45,24 por ciento por Cándida sp. La velocidad de cambio de los valores del lactato sérico en los infectados (p= 0,001) significó que por cada unidad en mmol/L que ascendió el lactato preoperatorio, en el posoperatorio se incrementó 0,489 mmol/L y estos cambios fueron debidos en 16,9 por ciento a los valores del lactato preoperatorio. Conclusiones: El lactato sérico está asociado a la infección en los neonatos intervenidos quirúrgicamente y es un biomarcador de sepsis útil en los cuidados intensivos neonatales(AU)

Introduction: The newborn undergoing a surgery is exposed to the development of infections. The serum lactate has been recommended as a diagnostic criterion of sepsis. Objective: To determine the magnitude of association of the value of serum lactate with sepsis in the newborn undergoing a surgery. Methods: Study conducted from 2013 to 2016 in William Soler Pediatric Teaching Hospital, to 307 newborns whom underwent surgery. The variables were grouped in: clinical (gestational age, birth weight, cause of surgical intervention, location of the infection) and paraclinical (causative microorganisms, serum lactate). The partial Pearson's test of linear correlation was applied and it was estimated the odds ratio with the control of the variable infection (yes and no) to identify correlation between serum lactate values in the preoperative and postoperative results. Results: Of the newborns, 63 were under weight (20.52 percent) and 55 were preterm infants (17.92 percent). In the infected newborns, 20.83 percent were operated due to digestive conditions (n= 35); systemic infections reached 67.74 percent (n= 42), caused in 45.24 percent by Candida sp. The rate of change of the values of serum lactate in infected subjects (p= 0.001) meant that for each unit in mmol/L in which increased the preoperative lactate, the postoperative increased 0.489 mmol/L; and these changes were due in a 16.9 percent to the values of preoperative lactate. Conclusions: The serum lactate is associated to the infection in newborns that underwent surgery and is a useful biomarker of sepsis in neonatal intensive care(AU)

Antibacterial efficacy of nisin, bacteriophage P100 and sodium lactate against Listeria monocytogenes in ready-to-eat sliced pork ham

ABSTRACT The effectiveness of bacteriophage P100, nisin and sodium lactate, individually and in combination, in inhibiting Listeria monocytogenes in ready-to-eat pork ham slices was assessed. The antimicrobials were applied to the surfaces of ready-to-eat pork ham slices, which were inoculated with a mixture of L. monocytogenes. Among the individual antimicrobial treatments, bacteriophage P100 was the most effective, decreasing L. monocytogenes to undetectable levels at zero and 72 h post-infection. Sodium lactate was the least effective treatment. Treatment with nisin at zero h significantly reduced initial cell density (p < 0.05). However, this pattern was not observed at 72 h of storage. A significant difference (p < 0.05) existed between the results of separate bacteriophage and nisin treatments after refrigerated storage, but not immediately upon inoculation of the bacteria. The results showed that the use of bacteriophage P100 is the method of choice for the control of bacteria.

Efeito alcalinizante de soluções eletrolíticas intravenosas com concentrações elevadas de lactato de sódio infundidas em bezerros sadios / Alkalinizing effect of intravenous electrolyte solutions with high sodium lactate concentrations infused in healthy calves

Com o objetivo de investigar o potencial alcalinizante de soluções eletrolíticas com concentrações elevadas de lactato de sódio em bezerros sadios, foram idealizadas seis soluções contendo 28, 56 e 84mEq/L de lactato (L28, L56 e L84) ou de bicarbonato (B28, B56 e B84), com concentrações de sódio, de potássio e de cálcio semelhantes às da solução de Ringer com lactato (SRL). As soluções contendo bicarbonato de sódio foram utilizadas como padrão para comparação. Seis bezerros receberam, por via intravenosa, todas as seis soluções, uma a cada vez, com intervalo de quatro a cinco dias entre as infusões, em volume correspondente a 10% do peso corporal, durante cinco horas (20mL/kg/h). Amostras de sangue venoso e de urina foram coletadas antes de iniciar a infusão, na metade do volume, ao término e duas horas e meia após o término da infusão. Determinaram-se concentração de proteína plasmática total, pH sanguíneo e urinário, pCO2, HCO3 -, BE, concentração plasmática e urinária de lactato L e concentrações séricas e urinárias de Na+, K+, Cl- e creatinina. A solução L28, idêntica à SRL, provocou discreto incremento da reserva alcalina e, consequentemente, produziu efeito alcalinizante insuficiente para a correção de estados de acidose metabólica. A solução L84, além de provar-se segura, provocou o maior aumento da reserva alcalina, equivalente à B84, e, assim, produziu efeito capaz de corrigir o grau moderado de acidose metabólica.

The alkalinizing effects of electrolyte solutions with high concentration of sodium lactate were evaluated in healthy calves. Six solutions were formulated containing 28, 56 and 84mEq/L of lactate (L28, L56 and L84) or bicarbonate (B28, B56 and B84), and sodium, potassium and calcium concentrations similar to the lactated Ringer's solution (LRS). The solutions containing sodium bicarbonate were used as a standard for comparison. Six calves received all six solutions intravenously, one at a time, with an interval of four to five days between the infusions, in a volume corresponding to 10% of body weight, during five hours (20mL/kg/h). Venous blood and urine samples were taken prior to the beginning of the infusion, at a half volume, at the end and two and a half hours after the end of the infusion. Total plasma protein concentration, urinary and blood pH, blood pCO2, HCO3 - and BE, plasma and urine L lactate concentration and serum and urine Na+, K+, Cl- and creatinine concentrations were measured. The L28 solution, equal to LRS, caused a slight increase in the alkaline reserve, producing an alkalinizing effect insufficient for correction of metabolic acidosis states. The L84 solution was safe and produced the greater increase in the alkaline reserve, equivalent to B84 solution, and suitable for correcting a moderate degree of metabolic acidosis.

Efecto del 3-nitropropionato sobre el metabolismo del lactato y del acetato en neuronas y astrocitos crecidos in vitro en concentraciones perinatales / Efeito do 3-nitropropionato sobre o metabolismo do lactato e do acetato em neuronios e astrocitos crescidos in vitro em concentrações perinatales / 3-Nitropropionate effect on the lactate and acetate metabolism of neurons and astrocytes grown in vitro with perinatal concentrations

Las reacciones anapleróticas son un mecanismo metabólico esencial para la continuidad postnatal del desarrollo cerebral, contribuyendo en procesos que requieren sustratos sintetizados a partir de intermediarios del ciclo de Krebs; sin embargo, se desconoce su papel en el neonato durante la prelactancia. Objetivo. Estimar la capacidad anaplerótica de neuronas y astrocitos crecidos in vitro. Materiales y métodos. Se midió el efecto del 3-nitropropionato (3-NPA)(2 mM), un inhibidor de Succinato Deshidrogenasa (SDH) sobre el metabolismo oxidativo y lipogénico de 14C derivados de acetato y lactato en concentraciones perinatales. Resultados. A pesar de la presencia del 3-NPA, se mantuvieron las velocidades de oxidación del lactato en neuronas y astrocitos en un 40 y 73% respectivamente y la lipogénesis en un 53 y 52% respectivamente. Con el acetato, la oxidación en neuronas y astrocitos se mantuvo en un 15 y 63% respectivamente, en tanto que la lipogénesis se mantuvo en astrocitos y aumentó en neuronas en un 174% (p<0,05). Todo esto comparado con sus respectivos controles sin inhibidor...

3-Nitropropionate effect on the lactate and acetate metabolism of neurons and astrocytes grown in vitro with perinatal concentrations.Anaplerotic reactions are an essential metabolic mechanism for the postnatal continuity of the brain development, contributing in processes that require substrates synthesized from Krebs cycle intermediates; however, their role during the presuckling period in theneonate is unknown. Objective. To estimate the anaplerotic capacity of neurons and astrocytes grown in vitro under perinatal conditions.Materials and methods. The effect of 3-nitropropionate (3-NPA)(2 mM) an inhibitor of the succinate dehydrogenase (SDH) on the oxidative and lipogenic metabolism of 14C-derived from acetate and lactate in perinatal concentrations. The results were compared with itsrespective controls without inhibitor. Results. In spite of the presence of 3-NPA, respiratory activity with lactate was 40% in neurons and73% in astrocytes, the lipogenesis was 53% in neurons and 52% in astrocytes. With acetate, the oxidation in neurons was 15% and 63% in astrocytes, lipogenesis was maintained in astrocytes but in neurons it increased up to 174% (p<0.05). Conclusions. These results demonstrate that in spite the oxalacetate depletion generated by 3-NPA, neurons as well as astrocytes are able to maintain the energeticmetabolism and the lipid synthesis using lactate or acetate thanks to the anaplerotic activity in the presuckling period. Additionally, astrocytes showed a capacity of buffering the effects of 3-NPA on the oxidation process greater than the neuron capacity. Neurons and astrocytes revealed a better capacity of directing acetate for lipid synthesis, activating the cytosolic acetyl-CoA synthetase pathway...

Efeito do 3-nitropropionato sobre o metabolismo do lactato e do acetato em neuronios e astrocitos crescidos in vitro em concentrações perinatales. As reações anapleróticas são um mecanismo metabólico essencial para a continuidade pos-natal do desenvolvimento cerebral,contribuindo nos processos que precisam substratos sintetizados a partir de intermediários do ciclo de Krebs. Embora, seu papel é desconhecido no neonato durante a prelactancia. Objetivo. Estimar a capacidade anaplerótica de neuronios e astrocitos crescidos in vitro.Materiais e métodos. Quantificou-se o efeito do 3-nitropropionato (3-NPA)(2 mM), um inibidor do Succinato Deshidrogenasa (SDH), sobre o metabolismo oxidativo e lipogénico de 14C derivados de acetato e lactato em concentrações perinatais. Resultados. A pesar da presença do 3-NPA, mantiveram-se as velocidades de oxidação do lactato em neuronas e astrocitos num 40 e 73% respectivamente e a lipogenesis em 53 e 52% respectivamente. Com o acetato, a oxidação em neuronas e astrocitos mantive-se num 15 a 63% respectivamente, no em tanto, a lipogénesis mantive-se em astrocitos e aumento em neuronas num 174% (p<0,05). Tudo o anterior comparado com seus respectivos controles sem inibidor. Conclusões. Estes resultados demonstram que a pesar da depleção do oxalacetato gerada pelo 3-NPA,as neuronas como os astrocitos são capazes de manter na prelactancia o metabolismo energético e a síntese de lípidos empregando lactato ou acetato devido à atividade anaplerótica. Adicionalmente, os astrocitos demonstraram ter maior capacidade de amortecer os efeitos do 3-NPA sobre a oxidação que as neuronas. As neuronas e os astrocitos apresentaram uma maior capacidade de dirigir o acetato para a síntese de lipídeos, ativando a via Acetil-CoA sintetasa citosólica...

Avaliação do comportamento anti-oxidante de sais orgânicos (acetato, citrato e lactato), em produtos cárneos frescais / Evaluation of the anti-oxidant of organic salts (acetate, citrate and lactate) in meat products

Os sais orgânicos vêm sendo investigados para uso em alimentos, devido à exigência dos consumidores por alimentos cada vez mais saudáveis, livres de substâncias que possam causar danos à saúde, a curto, a médio ou a longo prazo. Os ácidos orgânicos são considerados GRAS (Generally Recognized as Safe) para os alimentos, segundo a FDA (Food and Drug Administration) e têm sido indicados como aditivos naturais capazes de inibir ou retardar as alterações causadas por agentes físico-químicos ou microbiológicos. Este trabalho investigou o uso do acetato, do citrato e do lactato, nas concentrações de 1 por cento, 2 por cento e 3 por cento como agentes anti-oxidantes em lingüiças frescais de frango. A sua ação anti-oxidante foi medida através de análises de determinação do pH, determinação da acidez total e de índice de peróxido. Os dados foram avaliados através de análise de variância (ANOVA), tendo as suas médias agrupadas pelo teste de amplitude múltipla de Duncan, ao nível de 5 por cento. Foram considerados como fatores as concentrações do acetato, citrato e lactato (controle, 1 por cento, 2 por cento, 3 por cento). Os resultados indicaram que o citrato e o lactato de sódio apresentaram ação anti-oxidante mais pronunciada nas concentrações de 1 e 2 por cento.

Sodium lactate and ascorbic acid as preservative for fish fillets

Many undesirable changes can occur in the fish fillet during storage in retail market, due to microbial growth and fish spoilage, affording to evident economic loss. The effects of L-ascorbic acid [L-AA] and sodium lactate [SL], either alone or in combination, on the microbiological and chemical quality of Boulti fillet during storage at 0°C, were investigated. The results showed that addition of L-AA [0.05%] and SL [2.0%] alone or in combination [L-AA [0.05g] in SL 2.0%] significantly delayed the proliferation of aerobic plate counts, psychrotrophic counts and Pseudomonas bacteria extending, the product shelf life up to l2days, versus 6 days for control during the storage, the pH increase slowed down when the fish samples subjected to the treatment with preservative agents. The effect of lowering the pH was particularly pronounced when a combination of L-AA and SL used. L-AA alone or in combination with SL can successfully reduce the microbial growth, extending the shelf life of fillet during storage at 0°C

Effect of some cryoprotectant agents on physiochemical properties of frozen stored bolti [Tilapia Nilotica] fish fillets

The effectiveness of four cryoprotectant agents i.e. mixture of sucrose and sorbitol 8% [w/v] [S/S], sodium lactate 8% [w/v] [SL], sodium tripolyphosphate 11.8% [w/v] [STPP], and polydextrose 8% [w/v] [PDT] on protein denaturation of bolti fish fillets during freezing and frozen storage for 6 months were studied. The parameters of extractable proteins [salt and water-soluble factions], water holding capacity, total sulfhydryl content, and expressible moisture [drip under pressure] content were used to measure the protein denaturation. The used cryoprotectant agents were significantly [p<0.5] retarded protein denaturation during freezing storage [6 months]. Among all cryoprotectants used, polydextrose exhibited the greatest protective effect on protein denaturation as shown by the effectiveness in maintaining protein solubility. Sucrose/sorbitol provided more effective cryoprotection than sodium lactate in preservation of protein structure. Polydextrose and sodium lactate appeared to be promising alternative cryoportectants for fish muscle and its products owing to their low sweetness and caloric value

The use of composite sodium lactate and sorbitol composition in fluid resuscitation for shock in patients with major burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of the use of sodium lactate and sorbitol (CISS) in the fluid resuscitation for shock in patients with major burns.</p><p><b>METHODS</b>Fifty - three adult patients with major burns (hospitalized within 6 hours after burns) were randomly divided into A (n = 24, with i.v. infusion of 50 g/L CISS, 2 000 ml per day) and B (n = 29, with i. v. infusion of 50 g/L glucose, 2 000 ml per day) groups. The amount of electrolytes and colloid as the main resuscitation fluids was calculated according to the formula in both groups. Meanwhile, additional electrolytes and insulin were supplemented to the patients in the B group. The result of combating shock, energy supply, and side effects in the two groups were observed. The changes in hepatic and renal function, and the changes in electrolytes were monitored. The amount of fluid supplementation and urinary volume were recorded. The level of blood glucose of each patient was determined at the admission time and 24, 48, and 72 hours after injury.</p><p><b>RESULTS</b>No obvious difference was found in control of shock and energy supply between A and B group. There was no side effects or damage to hepatic and renal function related to infused fluids in A group. But the patients of the B group required supplementation of exra electrolytes and insulin during the fluid resuscitation period in order to maintain the normal levels of electrolytes and blood glucose, and this was not necessary in group A. The diuretic effect in group A was better than that in group B (average urinary volume in the first two 24 hours: group A: 1.9 +/- 0.6 and 3.3 +/- 0.8 L; group B:1.0 +/- 0.5 and 2.3 +/- 0.8 L).</p><p><b>CONCLUSION</b>The use of CISS during shock stage of the patients with major burns could be beneficial to the replenishment of blood volume, control of shock, promotion of diuresis and subsidence of edema. It could also provide electrolytes and energy, without the influence on the level of blood glucose.</p>

Fighting by sleep-deprived rats as a possible manifestation of panic: effects of sodium lactate

Increased fighting is an effect of desynchronized sleep deprivation (DSD) in rats, and recently this behavior has been suggested to be spontaneous panic and equivalent to panic disorder. In the present study we tested this hypothesis by evaluating the effect of sodium lactate on this aggressiveness, because this substance is recognized to induce spontaneous panic attacks in patients. A total of 186 male albino Wistar rats, 250-350 g, 90-120 days of age, were submitted to DSD (multiple platform method) for 0, 4, or 5 days. At the end of the deprivation period the rats were divided into subgroups respectively injected intraperitoneally with 1.86, 2.98 and 3.72 g/kg of 1 M sodium lactate, or 1.86 and 3.72 g/kg of 2 M sodium lactate. The control animals were submitted to the same procedures but received equivalent injections of sodium chloride. Regardless of DSD time, sleep-deprived animals that received sodium lactate presented a significantly higher mean number of fights (0.13 + or - 0.02 fights/min) and a longer mean time spent in confrontation (2.43 + or - 0.66 s/min) than the controls (0.01 + or - 0.006 fights/min and 0.12 + or - 0.07 s/min, respectively; P<0.01, Student t-test). For the sodium lactate group, concentration of the solution and time of deprivation increased the number of fights, with the mean number of fights and mean duration of fighting episodes being greater with the 2.98 g/kg dose using 1 M lactate concentration. These results support the hypothesis that fighting induced by DSD is probably a spontaneous panic manifestation. However, additional investigations are necessary in order to accept this as a promising animal model for studies on panic disorder

Role of minilaproscopy in evaluation of pelvic adhesions after laparoscopic ovarian electrocautery in patients with polycystic ovarian disease [PCO]

This study was performed to evaluate the incidence of pelvic adhesions after laparoscopic ovarian electrocautery, assess the efficacy of Lactated Ringer's solution in prevention of adhesions and lastly to compare the diagnostic accuracy of minilaparoscopy with that of 10 mm laparoscopic. Thirty-five patients with PCOD were selected for this study. These patients had bilateral laparoscopic ovarian drilling by unibolar electrocautery. Lactated Ringer's solution [500 cc] was left intraperitoneally at the end of the procedure in 22 cases designed as group I. While, no fluid was left in the other 13 cases designed as group II. Second-look laparoscopy was done 3-4 weeks later, first by minilaparoscope then by the standard 10 mm laparoscope. The overall incidence of adhesions in this study was 68.65% [24 cases out of 35]. Adhesions were less in group I [59.1%] than in group II [84.6%]. There was no statistically significant difference in the mean adhesion score by minilaparoscope and 10 mm laparoscope. However, there was a significant positive correlation [r = 0.856] when using either of them detect the adhesion score

Lactato de sódio: um conservante natural no processamento de lingüiça frescal / Salt of lactate

Com o objetivo de aumentar a vida de prateleira das lingüiças frescais, foi estudado o emprego de lactato de sódio em diferentes concentraçöes e a adiçäo de cultura "starter". As lingüiças foram submetidas a diferentes tratamentos, nos quais foi adicionado 2 por cento, 4 por cento e 6 por cento (peso/volume) de lactato de sódio e cultura "starter" Elce (1 envelope por 100 kg de massa). Foram realizadas contagens de microrganismos aeróbios mesófilos, psicotróficos e coliformes totais, logo após os tratamentos e durante o período de estocagem a 3§C. As amostras de lingüiças foram submetidas a um painel de degustadores para avaliaçäo dos atributos cor, aroma, sabor e textura. As amostras tratadas com 2 por cento de lactato de sódio apresentaram um aumento de 3 dias na vida útil das lingüiças e em média näo diferiram do controle quanto às características sensoriais. As amostras tratadas com 4 por cento e 6 por cento de lactato de sódio apresentaram contagens de microrganismos aeróbios mesófilos, psicotróficos e coliformes totais, menores do que o controle e prolongaram a vida de prateleira das lingüiças para os 33 dias de armazenagem. As características sensoriais melhoraram significativamente (P<0,05), sendo que o tratamento com 4 por cento de lactato de sódio foi o preferido pelos painelistas. Pelos resultados obtidos é viável o emprego de aditivos naturais contendo 4 por cento de lactato de sódio, visando aumentar a vida útil das lingüiças frescas, pois o uso deste conservante, além de qualificar o produto, prolonga o "shelf life" com maior segurança para o consumidor.

Nomograma hemodilucional (Z Na+ - Z K+) / Model for diagnosis of dilution-induced hyponatremia. The dilutional zone

Se propone un método para el diagnóstico de las hiponatremias dilucionales basado en un modelo que presenta gráficamente los valors estándar Z de las concentraciones de sodio y potasio sanguíneo. Del modelo se obtiene que ante variaciones en el contenido hídrico del plasma la natremia y la kalemia cambian en forma proporcional, desplazándose sobre una recta en el gráfico. La pendiente de la recta obtenida a partir del modelo fue comparada con las correspondientes a plasma y sangre entera (n=6) luego de un aporte creciente de solución dextrosada al 5 por ciento en agua en volúmenes equivalentes al 5,10,15,20 por ciento de la muestra. En ellas se determinó además el contenido de uremia, glucemia, sodio, potasio, gases en sangre y estado ácido-base. La pendiente del modelo resultó de 0,20, obteniéndose para el plasma 0,16 más menos 0,03 y para la sangre entera 0,10 más menos 0,03. En este último caso, las diferencias significativas con el modelo se justificaron por procesos globulares, asociados al metabolismo y a cambios en la osmolaridad. Se concluye pues que el modelo abarca dentro de la "zona dilucional" al comportamiento de la sangre entera y el plasma, siendo representativo de los efectos dilucionales. La experiencia clínica muestra asimismo el desplazamiento de los valores (Z Na+ - Z k+) sobre la zona dilucional en concordancia con el balance hídrico, y permite a la vez verificr su alejamiento cuando los cambios iónicos son determinados por causas no dilucionales que, sin llegar a ser un factor pronóstico, reflejan la evolución de la enfermedad

Hypertonic saline versus isotonic prehydration with spinal anaesthesia for elective cesarean section

Sixty healthy women [ASA I and II] at term undergoing elective cesarean section were allocated randomly to receive either lactated Ringer's 20 ml/kg body weight group I [30 partiurients] or 3% hypertonic saline 6 ml/kg body weight group II [30 parturients] over 15 minutes immediately before spinal anaesthesia as a preload. After spinal anaesthesia the incidence of hypotension was greater [43% "13/30"] in group I than in group II [17% "5/30]. Also, the main dose of ephedrine required to correct arterial blood pressure was significantly greater in group I than in group II. The outcome of the newborns was uneventful in both groups and Apgar scores at 1 and 5 minutes exceeded 8 in every case. Also, the mean pH of umbilical artery did not differ between the two groups. Prehydration with hypertonic saline 3% resulted in less hypotension after spinal anaesthesia than prehydration with isotonic saline [Lactated ringer]

Disociación de la respuesta de alarma ante una mezcla de cristaloides y coloides en la inducción anestésica en cirugía cardíaca

El objetivo de la investigación fue probar si la administración de líquidos durante la inducción de la anestesia, al restaurar el déficit de agua y expandirel volumen intravascular, atenuaria la respuesta hormonal normalmente producida en cirugía. Se realizó un estudio randomizado controlado, en un centro de atención terciaria, en treinta y seis pacientes programados para cirugía electiva de bypass aorto-coronario. Los criterios- de exclusión fueron: función miocárdica severamente- reducida o disfunción renal conocida. Doce pacientes recibieron 10 ml/kg de solución Ringer (grupo baja dosis de cristaloide LDC), 12 pacientes recibieron 15 ml/kg solución Ringer (grupo alta dosis de cristaloide HDC), y 12 pacientes recibieron una combinación de 10 ml/kg de solución Ringer más 10 ml/kg1 de solución hidroxietil-starch (HES) 450.000 daltons, grado de substitución 0,7 (grupo C-HES), dentro de un período de 20 minutos posterior a la inducción de la anestesia (fentanyl, midazolam, pancuronio). El índice cardíaco y el índice sistólico se incrementaron en 20 por ciento y 15 por ciento en el grupo C-HES mientras de al ADH, la renina y la aldosterona disminuyeron (18 por ciento, 18 por ciento, 43 por ciento) respectivamente, luego de la administración de volumen. Luego de la administración de volumen, los niveles plasmáticos de lso sistemas hormonales llamados a responder ante la deshidratación e hipovolemia disminuyeron en el grupo C-HES. En los otros dos grupos no se presentó ninguna mejoría del estado hemodinámico y las hormonas medidas permanecieron en el mismo nivel observado durante la inducción de la anestesia. No hubo diferencias intergrupales en el volumen total administrado o en l balance hídrico al final de la cirugía. La administración de una combinación de soluciones cristaloides y coloides siguiendo la inducción de la anestesia en pacientes con función ventricular preservada, programados para cirugía cardíaca, conduce a atenuar las respuesta normal de los sistemas hormonales que se observa durante los estados de deshidratación e hipovolemia, en tanto que la restricción de líquidos promueve la actividad de dichos sistemas hormales

Study of cutaneous hydration effect according to the vehicles of moisturizers / 대한피부과학회지

We investigated on how the nature of vehicles influenced on the efficacy of mo isturizer s, cutaneous hydrat,ion, physical property and roughness. Hydration was measured with corneometer, physical property with fermometer, and mughness with image analyser. Used vehicles were as follows : hydrous gel, vater in oil(W/0) emulsion, oil in water(0/W) emulsion. I.Jsed moisturizers were as follows . glycerine, polypeptide and sodium lactat,e, hyaluronic acid-triethanolamine, sodium lactate, pvopylene glycol, The results are summarized as follows : 1. The increment of the hydration effect according to vehicles was in this order. C/ W emulsion, W/0 emulsion, hydrous gel(After 2 hours). 2. The increment of extensibility as physical property was correlated to the in crcment, of hydration effcet(r=0.924). 3. It was shown that, the roughness was decreased after treatment of all mo isturizers except propylene glycol but, there was not significant st.atistically and alsa was no meaningful difference among the vehicles. 4. Among t,he moisturizers, glycerine was superior to other moisturizers on the hydration effect and extensihility. We conclude that 0/W emulsion was suitable vehicle on cutaneous hydration effect and hydration effect is proportion to the increment of flexibility.