Compound Sodium Lactate Research Articles

Intravenous fluid therapy compared to no treatment following blood donation in cats: a randomised controlled.

There is currently no consensus regarding the use of intravenous fluid therapy in feline patients post-blood donation in veterinary medicine. The primary aim of this study was to determine whether blood donation can be performed safely without post-donation intravenous fluid therapy. The secondary aim was to report owner-noted post-donation changes. The study aimed to enrol 100 conscious feline blood donations by client-owned cats performed at a veterinary teaching hospital. Donors were randomised to either receive intravenous compound sodium lactate (twice the volume of blood donated over 2 hours) immediately after blood donation, or to receive no post-blood donation intravenous fluid therapy. Systolic blood pressure was measured non-invasively at 0, 60 and 120 minutes post-donation. Median blood pressures were compared between the two groups using a Shapiro-Wilk test. Owners were called the day following the donation to collect information on changes in their cat post-donation. One hundred cats were enrolled and the data of 97 cats were analysed; 46 who received intravenous fluid therapy and 51 who did not. Mean donation volume was 9.95 mL/kg for the intravenous fluid therapy group and 9.72 mL/kg for the non-intravenous fluid therapy group. At each time point, the median blood pressure did not differ significantly between the two groups. The main reported changes in both goups were bruising at the venepuncture site with 27.3% (12/44) in the IVFT group and 23.4% (9/37) in the no-IVFT group, and mild lethargy up to a maximum of 24 hours post donation with 11.4% (5/44) in the IVFT group and 18.9% (7/37) in the no-IVFT group. This study suggests that the use of intravenous fluid therapy post-feline blood donation may not be necessary. This could mean reduced hospitalisation time for feline donors, possibly decreasing feline stress.

A randomised controlled trial of succinylated gelatin (4%) fluid on urinary acute kidney injury biomarkers in cardiac surgical patients

BackgroundFluid resuscitation is frequently required for cardiac surgical patients admitted to the intensive care unit. The ideal fluid of choice in regard to efficacy and safety remains uncertain. Compared with crystalloid fluid, colloid fluid may result in less positive fluid balance. However, some synthetic colloids are associated with increased risk of acute kidney injury (AKI). This study compared the effects of succinylated gelatin (4%) (GEL) with compound sodium lactate (CSL) on urinary AKI biomarkers in patients after cardiac surgery.MethodsCardiac surgical patients who required an intravenous fluid bolus of at least 500 mL postoperatively were randomly allocated to receive GEL or CSL as the resuscitation fluid of choice for the subsequent 24 h. Primary outcomes were serial urinary neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C concentrations measured at baseline, 1 h, 5 h and 24 h after enrolment, with higher concentrations indicating greater kidney injury. Secondary biomarker outcomes included urinary clusterin, α1-microglobulin and F2-isoprostanes concentrations. Differences in change of biomarker concentration between the two groups over time were compared with mixed-effects regression models. Statistical significance was set at P < 0.05.ResultsForty cardiac surgical patients (n = 20 per group) with similar baseline characteristics were included. There was no significant difference in the median volume of fluid boluses administered over 24 h between the GEL (1250 mL, Q1–Q3 500–1750) and CSL group (1000 mL, Q1–Q3 500–1375) (P = 0.42). There was a significantly greater increase in urinary cystatin C (P < 0.001), clusterin (P < 0.001), α1-microglobulin (P < 0.001) and F2-isoprostanes (P = 0.020) concentrations over time in the GEL group, compared to the CSL group. Change in urinary NGAL concentration (P = 0.68) over time was not significantly different between the groups. The results were not modified by adjustment for either urinary osmolality or EuroSCORE II predicted risk of mortality.ConclusionsThis preliminary randomised controlled trial showed that use of succinylated gelatin (4%) for fluid resuscitation after cardiac surgery was associated with increased biomarker concentrations of renal tubular injury and dysfunction, compared to crystalloid fluid. These results generate concern that use of intravenous gelatin fluid may contribute to clinically relevant postoperative AKI.Trial registration ANZCTR.org.au, ACTRN12617001461381. Registered on 16th October, 2017, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373619&isReview=true.

0.9% Sodium chloride solution versus Plasma-Lyte 148 versus compound sodium lacTate solution in children admitted to PICU\u2014a randomized controlled trial (SPLYT-P): study protocol for an intravenous fluid therapy trial

BackgroundIntravenous fluid therapy represents the most common intervention critically ill patients are exposed to. Hyperchloremia and metabolic acidosis associated with 0.9% sodium chloride have been observed to lead to worse outcomes, including mortality. Balanced solutions, such as Plasma-Lyte 148 and Compound Sodium Lactate, represent potential alternatives but the evidence on optimal fluid choices in critically ill children remains scarce. This study aims to demonstrate whether balanced solutions, when used as intravenous fluid therapy, are able to reduce the incidence of a rise in serum chloride level compared to 0.9% sodium chloride in critically ill children.MethodsThis is a single-centre, open-label randomized controlled trial with parallel 1:1:1 assignment into three groups: 0.9% sodium chloride, Plasma-Lyte 148, and Compound Sodium Lactate solutions for intravenous fluid therapy. The intervention includes both maintenance and bolus fluid therapy. Children aged < 16 years admitted to intensive care and receiving intravenous fluid therapy during the first 4 h of admission are eligible. The primary outcome measure is a ≥ 5mmol/L increase in serum chloride level within 48 h post-randomization. The enrolment target is 480 patients. The main analyses will be intention-to-treat.DiscussionThis study tests three types of intravenous fluid therapy in order to compare the risk of hyperchloremia associated with normal saline versus balanced solutions. This pragmatic study is thereby assessing the most common intervention in paediatric critical care.This is a single-centre open-label study with no blinding at the level of delivery of the intervention. Certain paediatric intensive care unit (PICU) patient groups such as those admitted with a cardiac condition or following a traumatic brain injury are excluded from this study.Trial registrationThe study has received ethical approval (HREC/19/QCHQ/53177: 06/06/2019). It is registered in the Australian New Zealand Clinical Trials Registry (ACTRN12619001244190) from 9th September 2019. Recruitment commenced on 12th November 2019. The primary results manuscript will be published in a peer-reviewed journal.

The hemodynamic effects of warm versus room-temperature crystalloid fluid bolus therapy in post-cardiac surgery patients.

The contribution of fluid temperature to the effect of crystalloid fluid bolus therapy (FBT) in post-cardiac surgery patients is unknown. We evaluated the hemodynamic effects of FBT with fluid warmed to 40°C (warm FBT) versus room-temperature fluid. In this single centre prospective before-and-after study, we evaluated the effects of 500 ml of warm versus room-temperature compound sodium lactate administered over <30 minutes, in 50 cardiac surgery patients admitted to ICU. We recorded hemodynamics continuous before and for 30 minutes after the first FBT. We defined CI responsiveness (CI-R) as an CI increase >15% of baseline immediately after FBT and effect dissipation if the CI returned to <5% of baseline and MAP responsiveness as >10% increase and dissipation as return to <3 mmHg of baseline. Hypotension (56%) and low CI (40%) typically triggered FBT. Temperature decreased >0.3°C in 13 (52%) patients after room-temperature FBT versus 0 (0%) after warm FBT (p < 0.01). CI and MAP responsiveness was similar (16 [64%] versus 11 [44%], p = 0.15 and 15 [60%] versus 17 [68%], p = 0.77, respectively). Among CI responders, CI increased more with room-temperature FBT (+0.6 [IQR, 0.5-1.1] versus +0.5 [IQR, 0.4-0.6] L/min/m2, p = 0.01). However, dissipation was more common after room-temperature versus warm FBT (9/16 [56%] versus 1/11 [9%], p = 0.02). In postoperative cardiac surgery patients, warm FBT preserved core temperature and induced smaller but more sustained CI increases among responders. Fluid temperature appears to impact both core temperature and the duration of CI response.

Characterisation of aluminium release by the enFlow® fluid-warming system in crystalloids and blood products.

The use of uncoated aluminium-heated plates in an intravenous fluid-warming system has been shown to produce high levels of aluminium in Sterofundin 1/1E, a balanced crystalloid solution. However, the effect of this fluid-warming device on other balanced crystalloid solutions and blood products has not been studied. Using mass spectrometry we measured aluminium levels in Plasma-Lyte 148, compound sodium lactate solution, 4% human albumin solution, expired resuspended packed red cells and fresh frozen plasma that were pumped through an enFlow® fluid-warming system at 2ml.min-1 . Samples were taken at baseline before heating and then at 10-min intervals up to 60min with the system set to warm the fluids to 40°C. High concentrations of aluminium were found for Plasma-Lyte 148 and compound sodium lactate solutions (mean (SD) 223 (0.6) μmol.l-1 and 163 (0.2) μmol.l-1 at 60min, respectively); both concentrations were significantly greater than the United States Food and Drug Administration recommended maximum limit for aluminium in intravenous nutrition of 25μg.l-1 (0.9 μmol.l-1 ). Lower aluminium levels were found in 4% human albumin solutions, expired resuspended red cells and fresh frozen plasma at 60min (mean (SD) 5.7 (0.1) μmol.l-1 , 2.7 (0.0) μmol.l-1 and 2.3 (0.4) μmol.l-1 , respectively). The process allowing addition of aluminium to be added to Sterofundin 1/1E by the enFlow fluid warmer also occurs in Plasma-Lyte 148 and compound sodium lactate solutions and to a lesser degree in blood products. The exact mechanism facilitating this process and its clinical significance remain unclear.

Alterations in regional kidney oxygenation during expansion of extracellular fluid volume in conscious healthy sheep.

Expansion of extracellular fluid volume with crystalloid solutions is a common medical intervention, but its effects on renal cortical and medullary oxygenation are poorly understood. Therefore, we instrumented sheep under general anesthesia to enable continuous measurement of systemic and renal hemodynamics, global renal oxygen delivery and consumption, and intrarenal tissue perfusion and oxygen tension (Po2) in conscious animals ( n = 7). The effects of three sequential intermittent infusions of 500 ml of compound sodium lactate solution, administered at hourly intervals, were determined. Volume expansion induced transient increases in mean arterial pressure (+7 ± 2%), central venous pressure (+50 ± 19%), and cardiac output (+15 ± 3%). There were sustained increases in renal medullary tissue Po2 (+35 ± 10%) despite increases in global renal oxygen consumption (+66 ± 18%) and renal oxygen extraction (+64 ± 8%). Volume expansion did not significantly alter renal blood flow, renal oxygen delivery, or medullary perfusion. The sustained increase in medullary Po2 was paralleled by increased bladder urine Po2 (34 ± 4%). Cortical perfusion and Po2 did not change significantly. Our findings indicate that extracellular fluid volume expansion can increase renal medullary oxygenation, providing a potential mechanistic basis for its use as prophylaxis against iatrogenic acute kidney injury. They also indicate that continuous measurement of bladder urine Po2 could be used to monitor the effects of volume expansion on medullary oxygenation. However, the mechanisms mediating increased medullary oxygenation during volume expansion remain to be determined.

Balanced Crystalloid Solution Versus Normal Saline on Biochemical Outcomes in Acute Medical and Surgical Patients

Background: Concerns have been raised regarding the use of various intravenous fluids resulting in hyperchloremic acidosis and associated acute kidney injury; however, this has primarily been in the context of resuscitation and critical care, and not ward-based medical or surgical patients who receive lower volumes of infusion fluid. We aimed to determine whether normal saline use is more likely to produce hyperchloremic metabolic acidosis than compound sodium lactate, in acute general medical and surgical patients. Methods: This was a retrospective study, conducted in 2015 in a metropolitan hospital in Melbourne, Australia, and of 1,158 sequentially admitted general medical and surgical patients receiving either intravenous normal saline or compound sodium lactate. Demographics, admission diagnosis, comorbidities, and medications were compared. Serum biochemistry results 24 - 48 h post-infusion were analyzed. Primary outcome was incidence of serum hyperchloremia post-infusion. In addition, mean shift in serum chloride concentration as well as mean normalized chloride concentration (mmol/L per day per L of infusion) were calculated. Acute kidney injuries and deaths during admission were also reported. Results: A total of 221 patients (169 medical and 52 surgical patients) were included for analysis (mean age 71.6 years, 72% female), with 174 normal saline and 61 compound sodium lactate infusions. No difference in hyperchloremia rate was found (normal saline vs. compound sodium lactate; n = 8 (4.6%) vs. n = 2 (3.3%), P = 1.0). Post-infusion serum chloride concentration was also not significantly different (99.0 ± 5.1 mmol/L vs. 100.0 ± 3.4 mmol/L, P = 0.1700) between infusion groups. Normal saline infusions resulted in an increase of mean normalized chloride concentration compared to compound sodium lactate (1.2 ± 4.0 mmol/L per day/L vs. -0.3 ± 1.5, P = 0.0121). Conclusions: We conclude that 2 - 3 L normal saline infusions in this population do not appear to be associated with hyperchloremic acidosis more frequently than compound sodium lactate infusions, allaying concerns of normal saline use in wards. World J Nephrol Urol. 2018;7(2):39-44 doi: https://doi.org/10.14740/wjnu339w

Lipopolysaccharides detection on a grating-coupled surface plasmon resonance smartphone biosensor

We report a smartphone label-free biosensor platform based on grating-coupled surface plasmon resonance (GC-SPR). The sensor system relies on the smartphone's built-in flash light source and camera, a disposable sensor chip with Au diffraction grating and a compact disk (CD) as the spectra dispersive unit. The Au grating sensor chip was modified with a synthetic peptide receptor and employed on the GC-SPR detection of lipopolysaccharides (known as endotoxins) with detection limit of 32.5ng/mL in water. Upon incubation of various small and macro-molecules with the synthetic peptide modified sensor chips, we concluded the good selectivity of the sensor for LPS detection. In addition, the sensor shows feasibility for the detection of LPS in commonly used clinical injectable fluids, such as clinical-grade 0.9% sodium chloride intravenous infusion, compound sodium lactate intravenous infusion and insulin aspart. The developed sensor platform offers the advantage of portability and simplicity, which is attractive for point-of-care and remote detection of biomedical and environmental targets.

Evaluation of the dynamic predictors of fluid responsiveness in dogs receiving goal-directed fluid therapy

ObjectivesGoal-directed fluid therapy (GDFT) based on pulse pressure variation (PPV) was used in anaesthetized dogs undergoing abdominal surgeries. The aims were 1) to evaluate the success rate of the PPV ≥13% in detecting fluid responsiveness [delta stroke volume (ΔSV) ≥10%]; 2) to assess the correlation between PPV, systolic pressure variation (SPV), Plethysmograph Variability Index (PVI) and central venous pressure (CVP) and 3) to establish the threshold value for the PVI that would predict a PPV value of ≥13% and indirectly discriminate responders from nonresponders to fluid therapy. Study designClinical, prospective, interventional study. AnimalsA total of 63 client-owned dogs scheduled for abdominal procedures. MethodsPPV and SPV were calculated manually from the invasive blood pressure trace on the Datex monitor. PVI was recorded from the Masimo pulse oximeter. Fluid challenge (10 mL kg−1 Compound Sodium Lactate) was performed when PPV was ≥13% and/or mean arterial pressure (MAP) < 60 mmHg. Fluid responsiveness was assessed by the transoesophageal Doppler probe. Cardiovascular parameters (heart rate, MAP, PPV, SPV, PVI, SV and if available, CVP) were measured before and after each fluid intervention. ResultsPPV ≥ 13% reliably predicted fluid responsiveness in 82.9% of cases. There was positive correlation between PPV and SPV (r = 0.84%), PPV and logPVI (r = 0.46) as well as SPV and logPVI (r = 0.45). Noninvasive PVI value ≥13% should predict PPV threshold value (13%) with 97% sensitivity and 68% specificity. There was no statistically significant correlation between PPV and CVP. ConclusionsPPV is a useful clinical tool to detect occult hypovolaemia and predict cardiovascular response to fluid challenge. Use of PPV is recommended as a part of GDFT in dogs undergoing abdominal procedures.

A study of Forward Osmosis Performance and its Application on Sodium Succinate Feed Solution Using Ionic Salt Draw Solution

Osmotically driven forward osmosis (FO) process is gaining increasing attentions among researchers. At present, the application of FO technology in the downstream recovery for biorefinery products is not common. With the increasing demand of energy intensive and economical technologies that are capable to concentrate dilute aqueous solutions, FO may find its potential in biorefinery application. In this paper, the osmotic pressure of different types of draw solution compound (sodium chloride, sodium acetate, sodium formate, ethylene glycol, and sodium lactate) was simulated. Experimental results were compared to the neutral compound and inorganic salt compound obtained from the previous literature and the performance of permeation flux was evaluated. It is desirable to carry out the FO process at higher draw solution concentration in order to achieve a fast water permeation process. The draw solution dilution effect was more pronounced at high solution concentration as a result of greater water permeation flux. Higher conductivities were obtained at increasing draw solution concentration indicating higher electrolyte concentration in the feed solution due to the reverse solute permeation. The application of FO technology for concentrating sodium succinate feed solution has shown encouraging results.&#x0D; Keywords : forward osmosis, osmotic pressure, water transport flux, conductivity, reverse solute permeation

Plasma Intermedin Level Indicates Severity and Treatment Efficacy of Septic Shock in Sprague-Dawley (SD) Rats.

BackgroundThe aim of this study was to investigate the value of plasma intermedin (IMD) in assessing severity and treatment efficacy of septic shock.Material/MethodsHealthy male Sprague-Dawley (SD) rats were chosen and divided into a normal control group (n=15) and a shock model group (n=27) that received intravenous injection of lipopolysaccharide (LPS). Then, 3 specimens were taken from each group. The shock model group rats were divided into an LPS group and a treatment group with 12 rats each. The treatment group received intravenous injection of compound sodium lactate solution. Plasma IMD and IMD1-47 mRNA expressions were compared and analyzed.ResultsMean arterial pressure (MAP) was lower while white blood cell count and TNF-α were higher in the shock model group than in the normal control group (P<0.05). After 10 h and 20 h, the treatment group had lower plasma IMD and IMD1-47 mRNA expressions compared with the LPS group (P<0.05). Plasma IMD and IMD1-47 mRNA expressions in the LPS group after 20 h were significantly higher than after 10 h (P<0.05). IMD was positively correlated with interleukins (IL-3, IL-6, and IL-8), white blood cell count, and body temperature (all P<0.05), but were negatively correlated with systolic pressure (r=−0.8474, P=0.0040).ConclusionsPlasma IMD level can effectively reflect the severity of septic shock and can be used as an important indicator of septic shock treatment effectiveness.

Comparative efficacy of BioRelease Deslorelin® injection for induction of ovulation in oestrus mares: a field study.

To investigate the comparative efficacy of BioRelease Deslorelin® (BRD) and Ovuplant® for induction of ovulation in cyclic mares in Australia. Ovarian follicular activity of 60 mares for a total of 95 cycles was monitored by ultrasonography until they developed a follicle ≥30 mm and a uterine oedema pattern of 3. Mares were then randomly allocated to one of three treatment groups: (1) treatment with 1.25 mg BRD, (2) a single Ovuplant pellet or (3) 1 mL compound sodium lactate control. Follicular activity was monitored with ultrasonography every 12 h until ovulation was detected or for at least 5 days post treatment. The injection site on each mare was monitored for reaction for a minimum of 5 days post treatment. There was no difference in the percentage of mares ovulating within 48 h when treated with BRD (93.75%) compared with Ovuplant (87.09%). Treatment with both ovulating agents significantly decreased the time to ovulation compared with control mares (P < 0.00005). More mares had injection site reactions with Ovuplant (64.5%) treatment compared with BRD (15.6%) or control mares (0%) (P < 0.00005). Treatment of mares with 1.25 mg BRD when there is a follicle ≥30 mm and uterine oedema pattern of 3 is as effective as treatment with Ovuplant.

Characteristics and expectations of fluid bolus therapy: a bi-national survey of acute care physicians.

There is little consensus on the definition or optimal constituents of fluid bolus therapy (FBT), and there is uncertainty regarding its physiological effects. The aims of this study were to determine clinician-reported definitions of FBT and to explore the physiological responses clinicians expect from such FBT. In June and October 2014, intensive care and emergency physicians in Australia and New Zealand were asked to participate in an electronic questionnaire of the reported practice and expectations of FBT. Two hundred and fifty-one questionnaires were completed, 65.3% from intensivists. We identified the prototypical FBT given by intensivists is more than 250 ml of compound sodium lactate, saline or 4% albumin given in less than 30 minutes, while that given by emergency department physicians is a similar volume of saline delivered over a similar time frame. Intensive care and emergency physicians expected significantly different changes in mean arterial pressure (P=0.001) and heart rate (P=0.033) following FBT. Substantial variation was demonstrated in the magnitude of expected response within both specialties for each variable. Major variations exist in self-reported FBT practice, both within and between acute specialties, and wide variation can be demonstrated in the expected physiological responses to FBT. International explorations of practice and prospective quantification of the actual physiological response to FBT are warranted.

Evaluation of the effect of intra-operative intravenous fluid on post-operative pain and pulmonary function: a randomized trial comparing 10 and 30 ml kg−1 of crystalloid

Existing evidence suggests that administration of intravenous fluids has been shown to improve outcomes including pain in gynecological laparoscopic surgery but the optimum fluid dose has not been determined. To determine the effect of administration of intravenous fluids on post-operative pain and pulmonary function after gynecological laparoscopy. In a prospective randomized double-blinded study 100 ASA 1 and 2 elective patients undergoing gynecological laparoscopy were randomized to receive intravenous compound sodium lactate 10 ml kg(-1) (CSL10-restrictive) or 30 ml kg(-1) (CSL30-liberal) administered intra-operatively. The primary outcome measure was the post-operative pain score at 24, 48 and 72 h, assessed by 0-10 verbal rating scale (VRS). Pulmonary function (FEV1, FVC, PEFR) and oxygen saturation were also measured. Patients who received CSL 30 had lower post-operative pain scores than CSL 10 (ANCOVA-mean difference = 0.47, 95 % CI 0.11-0.83, P = 0.01). Post-operative pain VRS was lower in CSL30 than CSL10 at 48 h (mean difference 0.56, 95 % CI 0.04-1.09, P = 0.036). Patients in CSL30 reported shoulder tip pain less frequently than those in CSL10 (30.4 vs. 43.9 % of assessments, P = 0.03, OR 0.58) but reported wound pain more frequently 39.0 vs. 24.2 %, P = 0.01, OR 2.0). Indices of pulmonary function did not differ between groups at any time. Liberal compared to restrictive administration of i.v. crystalloid is associated with a clinical modest reduction in pain. Pulmonary dysfunction was not increased with liberal fluid administration.

Use of calcium folinate in the management of accidental methotrexate ingestion in two dogs

2 English Pointers were suspected of having consumed toxic doses of methotrexate, a dihydrofolate reductase inhibitor frequently used in human and veterinary chemotherapeutic protocols. Potentially toxic plasma concentrations of methotrexate were detected in both dogs. Results of physical examination, a CBC, blood gas analysis, and serum biochemical analysis were predominantly unremarkable, although 1 dog had mild hyponatremia (1372 mmol/L; reference range, 140 to 153 mmol/L) and mild hypocalcemia (1.03 mmol of ionized calcium/L; reference range, 1.13 to 1.33 mmol of ionized calcium/L). Point-of-care determination of plasma methotrexate concentrations was not available; thus, palliative care was provided. Emesis was induced in both dogs by SC administration of apomorphine, and 3 doses of a suspension of activated charcoal with sorbitol were administered orally over a 6-hour period. Fluid diuresis was initiated in both dogs by administration of a compound sodium lactate solution, and N-acetylcysteine was administered IV to both dogs as a hepatoprotectant. A solution of calcium folinate (also known as leucovorin) was administered IV to both dogs to mitigate the effects of ingested methotrexate. No adverse effects associated with calcium folinate administration were identified, and no clinical or pathological evidence of methotrexate intoxication was detected. IV administration of calcium folinate appeared to prevent the pathological sequelae of methotrexate intoxication without adverse effects. Administration of calcium folinate is recommended for the treatment of dogs with suspected or confirmed methotrexate overdose.

Cooling intravenous fluids by refrigeration: implications for therapeutic hypothermia

Background:ILCOR recommend the use of therapeutic hypothermia (32–34°C) for 12–24 h in unconscious adult patients with spontaneous circulation after cardiac arrest with a VF rhythm. Among various methods of inducing...

Clinical observation of effective and security of pre-anesthetic hypervolemic hemodilution with polyglucose before cesarean section

Objective To observe the effects and security of pre-anesthetic hypervolemic hemodilution with polyglucose sodium chloride on patients under cesarean section combined with spinal-epidural anesthesia. Methods 50 patients were randomly divided into two groups. 25 cases were injected with polyglucose sodium chloride as polyglucose sodium chloride injection (PG) group and 25 cases were injected with compound sodium lactate as compound sodium lactate(RL) group. The changes of mean arterial pressure, (MAP), heart rate (HR), Hct, pH, Glu, APTT and PT before and after pre-anesthetic hypervolemic hemodilution, 5 min, 10min, 15min and 20min after anesthesia were registered.The cases which were injected ephedrine after anesthesia or with low postoperative blood pressure, infusion adverse reactions, anesthesia time and surgical time were also recorded and analyzed. Results The MAP and HR in RL group after anesthesia were significantly different from that before, anesthesia and that in PC, group (P<0.01). After pre-anesthetic hypervolemic hemodilution, the Hct, pH, Glu, APTT, PT changed significantly (P<0.05 or 0.01), but still within normal range. After anesthesia, there were 5 cases with low blood pressure in PG group and 12 cases in RL group. After operation, there were 7 cases with low blood pressure in PG group and 4 cases in RL group. All the cases did not have adverse reactions. Conclusion The pre-anesthetic hypervolemic hemodilution with polyglucose sodium chloride on patients undertaking cesarean section can effectively resist the cardiovascular changes produced by combined spinal-epidural anesthesia. Appropriate use will not significantly affect the blood coagulation or blood sugar. Key words: Cesarean section; Polyglucose; Pre-anesthetic hypervolemic hemedilution; Effects; Security

Effect of intravenous crystalloid infusion on postoperative nausea and vomiting after thyroidectomy: a prospective, randomized, controlled study

Intravenous administration of compound sodium lactate (CSL) 30 ml kg to women undergoing gynaecological laparoscopy reduced the incidence of vomiting, nausea and antiemetic use when compared with 10 ml kg. The aim of this study was to evaluate the effect of intravenous fluid administration on nausea and vomiting after thyroidectomy. With ethics committee approval, 100 patients scheduled for thyroid surgery were included in this prospective, controlled, double blind study. Patients were randomized into two groups: the CSL-10 group (n = 50) received CSL 10 ml kg and the CSL-30 group received CSL 30 ml kg; the administration of fluid was completed by the end of surgery. Standardized anaesthesia was performed. The incidence of nausea and vomiting and need for antiemetics and analgesic therapy were assessed by a blinded observer at 0.5, 2, 6, 12, 18 and 24 h after surgery. Patients' satisfaction was also recorded (0-100). The incidence of nausea (64%) was similar in both groups (P = 0.1). The incidence of vomiting was 34% in the CSL-10 group and 32% in the CSL-30 group (P = 0.83). Antiemetics (P = 0.84) and analgesic consumption (P = 0.72) did not differ significantly between the two groups. Patients' satisfaction was also comparable (P = 0.39). Intravenous administration of CSL 30 ml kg to patients undergoing thyroidectomy did not reduce the incidence of nausea, vomiting and antiemetic use when compared with CSL 10 ml kg.

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The effect of a single intravenous fluid bolus on packed cell volume and plasma total solids concentration in Red‐collared Lorikeets (Trichoglossus haematodus rubritorquis)

To determine the effect of a single intravenous (IV) fluid bolus on the hydration of an avian patient, using packed cell volume (PCV) and plasma total solids (TS) to estimate hydration. Ten birds were allocated randomly to one of three groups, and administered 30 mL/kg or 50 mL/kg intravenous fluid, or were part of a control group and did not receive IV fluid. Blood was collected before the IV fluid bolus was administered, and at 1 minute, 3 hours and 6 hours after administration of the fluid. Samples were used to determine PCV and TS and results were compared between groups and between the different time points. Administration of 30 mL/kg or 50 mL/kg compound sodium lactate solution caused a statistically significant decrease in PCV. Within 3 hours, the PCV was not significantly different to the initial value or to the PCV of control birds. Administration of 30 mL/kg compound sodium lactate solution did not result in a significant decrease in TS. However, administration of 50 mL/kg produced a significant decrease in TS, which was still significantly less than controls 6 hours after the fluid was administered. These findings suggest that an intravenous bolus of fluid may be safely administered to an anaemic bird, since PCV is significantly decreased for less than 3 hours. Up to 50 mL/kg of fluid may be administered as an intravenous bolus to a bird, to produce significant haemodilution that persists for up to 6 hours.