Administration of Hypertonic Solutions for Hemorrhagic Shock: A Systematic Review and Meta-analysis of Clinical Trials

@article{Wu2017AdministrationOH,
  title={Administration of Hypertonic Solutions for Hemorrhagic Shock: A Systematic Review and Meta-analysis of Clinical Trials},
  author={Meng-Che Wu and Tin-Yun Liao and Erica M Lee and Yueh-Sheng Chen and Wan-Ting Hsu and Meng-tse Gabriel Lee and Po-Yang Tsou and Shyr-Chyr Chen and Chien-Chang Lee},
  journal={Anesthesia \& Analgesia},
  year={2017},
  volume={125},
  pages={1549–1557}
}
BACKGROUND: Several clinical trials on hypertonic fluid administration have been completed, but the results have been inconclusive. The objective of this study is to summarize current evidence for treating hypovolemic patients with hypertonic solutions by performing a systematic review and meta-analysis. METHODS: Major electronic databases were searched from inception through June 2014. We included only randomized controlled trials involving hemorrhagic shock patients treated with hypertonic… Expand
Higher Concentration of Hypertonic Saline Shows Better Recovery Effects on Rabbits with Uncontrolled Hemorrhagic Shock
TLDR
The novel fluid combination with 7.5% hypertonic saline group had a better recovery effect at the early stage of UHS before hemostasis compared to that of the 4.5%, and this result may provide guidance for clinical fluid resuscitation. Expand
Hyperchloremia is not associated with AKI or death in septic shock patients: results of a post hoc analysis of the “HYPER2S” trial
TLDR
The relationship between serum chloride concentration and both renal function and survival in patients with septic shock and hyperchloremia was examined to assess the association between chloride parameters, day-28 mortality and AKI. Expand
The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition
TLDR
The guideline now recommends that patients be transferred directly to an appropriate trauma treatment centre and encourages use of a restricted volume replacement strategy during initial resuscitation, and may also serve as a basis for local implementation. Expand
Fluid Stewardship During Critical Illness: A Call to Action
TLDR
The proposed principle of “fluid stewardship,” guided by 4 rights of medication safety: right patient, right drug, right route, and right dose, will aid pharmacists in making decisions regarding IVF therapy to optimize hemodynamic management and improve patient outcomes. Expand
The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition
TLDR
Advances in the understanding of the pathophysiology of post-traumatic coagulopathy have supported improved management strategies, including evidence that early, individualised goal-directed treatment improves the outcome of severely injured patients. Expand
Systematic Review and Meta-analysis: Sometimes Bigger Is Indeed Better
  • T. Vetter
  • Medicine
  • Anesthesia and analgesia
  • 2019
TLDR
The present basic statistical tutorial thus focuses on the fundamentals of a systematic review and meta-analysis, against the backdrop of practicing evidence-based medicine. Expand
Evaluation of novel formulations of d‐&bgr;‐hydroxybutyrate and melatonin in a rat model of hemorrhagic shock
TLDR
ABSTRACT d‐&bgr;‐hydroxybutyrate and melatonin (BHB/MLT) infusion improves survival in hemorrhagic shock models and constitute promising candidates for clinical hemorrhagicshock treatment. Expand
Sevoflurane postconditioning improves spatial learning and memory ability involving mitochondrial permeability transition pore in hemorrhagic shock and resuscitation rats
TLDR
The aim of the study was to find out the precise mechanism of the sevoflurane postconditioning and to provide neuroprotection against ischemic–reperfusion injury. Expand
Management of Blunt Solid Organ Injuries: the Indian Society for Trauma and Acute Care (ISTAC) Consensus Guidelines
Abdominal trauma management has seen a paradigm shift over the last few decades. There is wide variation in the treatment depending on the level of healthcare facilities available. With an aim toExpand
...
1
2
...

References

SHOWING 1-10 OF 49 REFERENCES
Efficacy of hypertonic 7.5% saline and 6% dextran-70 in treating trauma: a meta-analysis of controlled clinical studies.
TLDR
A fixed-effects meta-analysis of the available data shows that HS is not different from the standard of care and that HSD may be superior, and overall, HS was not effective in improving survival. Expand
PROGNOSTIC FACTORS TO PREDICT OUTCOME FOLLOWING THE ADMINISTRATION OF HYPERTONIC/HYPERONCOTIC SOLUTION IN HYPOVOLEMIC PATIENTS
TLDR
Multivariate analyses showed that RTS and MAP were identified as independent predictors for 24 h survival in the group that received HSD, and hypertonic infusion benefited significantly only patients with MAP <70 mmHg (p < .01). Expand
Out-of-hospital Hypertonic Resuscitation After Traumatic Hypovolemic Shock: A Randomized, Placebo Controlled Trial
TLDR
Among injured patients with hypovolemic shock, initial resuscitation fluid treatment with either HS or HSD compared with NS, did not result in superior 28-day survival, and interpretation of these findings is limited by the early stopping of the trial. Expand
Hypertonic solutions in the treatment of hypovolemic shock: a prospective, randomized study in patients admitted to the emergency room.
TLDR
Infusion of 250 ml hypertonic saline solution in patients with severe hypovolemia was not related to any complications, nor did it affect mortality rates; it improved MAP significantly, acutely expanded plasma volume by 24%, and reduced significantly the volumes of crystalloids and blood required in their resuscitation. Expand
Analysis of potential risks associated with 7.5% sodium chloride resuscitation of traumatic shock.
TLDR
Eight patients had a significant hyperchloremic acidemia in association with infusion of the hypertonic solutions, but all eight were moribund before infusion and many factors other thanhyperchloremia could have contributed to their acidemia. Expand
Hypertonic resuscitation: physiologic mechanisms and recommendations for trauma care.
TLDR
Several perioperative and eight randomized, blinded trauma trials have shown safety and reduced volume needs and suggest increased survival, particularly in head- and penetrating-injury patients. Expand
Prehospital resuscitation of hypotensive trauma patients with 7.5% NaCl versus 7.5% NaCl with added dextran: a controlled trial.
TLDR
The 7.5% NaCl solution significantly improved upon the predicted survival for the entire cohort and for high-risk patients when compared with the survival estimates from the TRISS methodology. Expand
The hypertonic saline trial: a possible downside to the gold standard of double blinding.
TLDR
The trial by Bulger et al,9 in this issue of Annals of Surgery, is the largest clinical trial to date on the out-of-hospital use of hypertonic versus isotonic resuscitation and shows tendencies for improved long-term survival withhypertonic saline. Expand
Out-of-hospital hypertonic resuscitation following severe traumatic brain injury: a randomized controlled trial.
TLDR
Among patients with severe TBI not in hypovolemic shock, initial resuscitation with either hypertonic saline or hypertonics saline/dextran, compared with normal saline did not result in superior 6-month neurologic outcome or survival. Expand
Prehospital hypertonic saline/dextran infusion for post-traumatic hypotension. The U.S.A. Multicenter Trial.
TLDR
Although this trial demonstrated trends supportive of HSD in hypotensive hemorrhagic shock patients requiring surgery, a larger sample size will be required to establish which subgroups of trauma patients might maximally benefit from the prehospital use of a small volume of hyperosmolar solution. Expand
...
1
2
3
4
5
...