BACKGROUND Fibrinogen concentrate treatment can improve coagulation during massive traumatic bleeding. The aim of this in vitro study was to determine whether fibrinogen concentrate, or a combination of factor XIII and fibrinogen concentrates, could reverse a haemodilution-induced coagulopathy during hypothermia. METHODS Citrated venous blood from 10 healthy volunteers was diluted in vitro by...

BACKGROUND Haemorrhage follows surgical intervention, but also fluid substitution may affect the blood loss. Here influence of colloids and lactated Ringer's solution (LR) on coagulation competence and haemorrhage is evaluated during cystectomy. METHODS A meta-analysis, a prospective observational study and three randomized controlled trials were conducted - 17 patients received HES 130/0.4, ...

To the Editor: Martin et al.1 described a meta-analysis of 17 randomized controlled trials evaluating renal function in 1,230 total surgical patients allocated to hydroxyethyl starch (HES) 130/0.4 or control fluid. At baseline, mean serum creatinine (SCr) was lower in HES 130/0.4 recipients than the control group, and after surgery, the most extreme mean SCr values were higher in the patients r...

Objective: To explore a good strategy for fluid therapy, we observed the effect of application of LiDCO-Rapid on peri-operative hypotension and complications in aged patients undergoing total hip replacement, performed under combined spinal-epidural anesthesia (CSEA). Methods: Forty patients were randomly divided into normal fluid therapy group (group N) and LiDCO-Rapid guiding fluid therapy gr...

INTRODUCTION The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen (O₂) supply during acute normovolemic anemia has not been investigated so far. METHODS Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia toleranc...

INTRODUCTION Fluid resuscitation is an indispensable procedure in the acute management of hemorrhagic shock for restoring tissue perfusion, particularly microcirculation in splanchnic organs. Resuscitation fluids include crystalloids, hypertonic saline (HTS), and synthetic colloids, and their selection affects the recovery of microcirculatory blood flow and reactive oxygen species (ROS) formati...

cacy of hydroxyethyl starch (HES) versus NaCl in patients with severe sepsis requires an algorithm to direct the timing and amount of fl uid resuscitation. Such an algorithm may include hemodynamic fl ow parameters. In a recent issue of Critical Care, Guidet and colleagues [1] reported that a smaller amount of 6% HES 130/0.4 versus 0.9% NaCl was required to achieve hemodynamic stability (HDS) d...

BACKGROUND Controversy exists regarding the optimal i.v. fluids for use with a goal-directed haemodynamic algorithm. METHODS In a double-blind pilot study, we randomly assigned 50 patients with primary ovarian cancer undergoing cytoreductive surgery to receive either balanced crystalloid or balanced starch (HES, 130/0.4, 6%) solutions up to the dose limit (50 ml kg(-1)). Fluids were administe...