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| 1 | Intestinal injury can be reduced by intra-arterial postischemic perfusion with hypertonic saline显示文摘AIM:To investigate the effect of local intestinal perfusion with hypertonic saline(HTS) on intestinal ischemia-reperfusion injury(IRI) in bothex vivo andin vivo rat models.METHODS:All experiments were performed on male Wistar rats anesthetized with pentobarbital sodium given intraperitoneally at a dose of 60 mg/kg.Ex vivo vascularly perfused rat intestine was subjected to 60-min ischemia and either 30-min reperfusion with isotonic buffer(controls),or 5 min with HTS of 365 or 415 mOsm/L osmolarity(HTS 365mOsm or HTS 415mOsm,respectively) followed by 25-min reperfusion with isotonic buffer.The vascular intestinal perfusate flow(IPF) rate was determined by collection of the effluent from the portal vein in a calibrated tube.Spontaneous intestinal contraction rate was monitored throughout.Irreversible intestinal injury or area of necrosis(AN) was evaluated histochemically using 2.3.5-triphenyltetrazolium chloride staining.In vivo,30-min ischemia was followed by either 30-min blood perfusion or 5-min reperfusion with HTS 365mOsm through the superior mesenteric artery(SMA) followed by 25-min blood perfusion.Arterial blood pressure(BP) was measured in the common carotid artery using a miniature pressure transducer.Histological injury was evaluated in both preparations using the Chui score.RESULTS:Ex vivo,intestinal IRI resulted in a reduction in the IPF rate during reperfusion(P < 0.05 vs sham).The postischemic recovery of the IPF rate did not differ between the controls and the HTS 365mOsm group.In the HTS 415mOsm group,postischemic IPF rates were lower than in the controls and the HTS 365mOsm group(P < 0.05).The intestinal contraction rate was similar at baseline in all groups.An increase in this parameter was observed during the first 10 min of reperfusion in the control group as compared to the sham-treated group,but no such increase was seen in the HTS 365mOsm group.In controls,AN averaged 14.8% ± 5.07% of the total tissue volume.Administration of HTS 365mOsm for 5 min after 60-min ischemia resulted in decrease in AN(5.1% ± 1.20% vs controls,P < 0.01).However,perfusion of the intestine with the HTS of greater osmolarity(HTS 415mOsm) failed to protect the intestine from irreversible injury.The Chiu score was lower in the HTS 365mOsm group in comparison with controls(2.4 ± 0.54 vs 3.2 ± 0.44,P = 0.042),while intestinal perfusion with HTS 415mOsm failed to improve the Chiu score.Intestinal reperfusion with HTS 365mOsm in the in vivo series secured rapid recovery of BP after its transient fall,whereas in the controls no recovery was seen.The Chiu score was lower in the HTS 365mOsm group vs controls(3.1 ± 0.26 and 3.8 ± 0.22,P = 0.0079 respectively,),although the magnitude of the effect was lower than in the ex vivo series.CONCLUSION:Brief intestinal postischemic perfusion with HTS 365mOsm through the SMA followed by blood flow restoration is a protective procedure that could be used for the prevention of intestinal IRI. | Oleg Kornyushin Michael Galagudza Anna Kotslova Gelfia Nutfullina Nina Shved Alexey Nevorotin Valeriy Sedov Timur Vlasov | 2013 | World Journal of Gastroenterology2013，19，2： | 4 |
| 2 | N-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and hypertonic glucose with 72% chromated glycerin in gastric varices显示文摘AIM: To compare n-butyl-2-cyanoacrylate, iso-amyl-2-cyanoacrylate and a mixture of 72% chromated glycerin with hypertonic glucose solution in management of gastric varices. METHODS: Ninety patients with gastric varices presented to Endoscopy Unit of Ain Shams University Hospital were included. They were randomly allocated into three groups; each group included 30 patients treated with intravariceal sclerosant injections in biweekly sessions till complete obturation of gastric varices; Group I(n-butyl-2-cyanoacrylate; Histoacryl), Group II(iso-amyl-2-cyanoacrylate; Amcrylate) and Group III(mixture of 72% chromated glycerin; Scleremo with glucose solution 25%). All the procedures were performed electively without active bleeding. Recruited patients were followed up for 3 mo. RESULTS: 26% of Scleremo group had bleeding during puncture vs 3.3% in each of the other two groups with significant difference,(P < 0.05). None of Scleremo group had needle obstruction vs 13.3% in each of the other two groups with no significant difference,(P > 0.05). Rebleeding occurred in 13.3% of Histoacryl and Amcrylate groups vs 0% in Scleremo group with no significant difference. The in hospital mortality was 6.6% in both Histoacryl and Amcrylate groups, while it was 0% in Scleremo group with no significant difference. In the first and second sessions, the amount of Scleremo needed for obturation was significantly high, while the amount of Histoacryl was significantly low. Scleremo was the less costly of the two treatments. CONCLUSION: All used sclerosant substances showed efficacy and success in management of gastric varices with no significant differences except in total amount, cost and bleeding during puncture. | Reda Elwakil Mohamed Fawzy Montasser Sara M Abdelhakam Wesam A Ibrahim | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，4： | 3 |
| 3 | Variable change in renal function by hypertonic saline显示文摘AIM: To investigate the effects of hypertonic saline in the neurocritical care population.METHODS: We retrospectively reviewed our hospital's use of hypertonic saline(HS) since March of 2005, and prospectively since October 2010. Comparisons were made between admission diagnoses, creatinine change(Cr), and HS formulation(3% Na Cl, 3% Na Cl/sodium acetate mix, and 23.4% Na Cl) to patients receiving normal saline or lactated ringers. The patients(n = 1329) of the retrospective portion were identified. The data presented represents the first 230 patients with data. RESULTS: Significant differences in Acute Physiology and Chronic Health Evaluation Ⅱ scores and GlasgowComa Scale scores occurred between different saline formulations. No significant correlation of Cl- or Na+ with Cr, nor with saline types, occurred. When dichotomized by diagnosis, significant correlations appear. Traumatic brain injury(TBI) patients demonstrated moderate correlation between Na+ and Cr of 0.45. Stroke patients demonstrated weak correlations between Na+ and Cr, and Cl- and Cr(0.19 for both). Patients receiving HS and not diagnosed with intracerebral hemorrhage, stroke, subarachnoid hemorrhage, or TBI demonstrated a weak but significant correlation between Cl- and Cr at 0.29.CONCLUSION: Cr directly correlates with Na+ or Cl- in stroke, Na+ in TBI, and Cl- in other populations. Prospective comparison of HS and renal function is needed. | Jesse J Corry Panayiotis Varelas Tamer Abdelhak Stacey Morris Marlisa Hawley Allison Hawkins Michelle Jankowski | 2014 | World Journal of Critical Care Medicine2014，3，2： | 3 |
| 4 | From bronchiolitis guideline to practice: A critical care perspective显示文摘Acute viral bronchiolitis is a leading cause of admission to pediatric intensive care units, but research on the care of these critically ill infants has been limited. Pathology of viral bronchiolitis revealed respiratory obstruction due to intraluminal debris and edema of the airways and vasculature. This and clinical evidence suggest that airway clearance interventions such as hypertonic saline nebulizers and pulmonary toilet devices may be of benefit, particularly in situations of atelectasis associated with bronchiolitis. Research to distinguish an underlying asthma predisposition in wheezing infants with viral bronchiolitis may one day lead to guidance on when to trial bronchodilator therapy. Considering the paucity of critical care research in pediatric viral bronchiolitis, intensive care practitioners must substantially rely on individualization of therapies based on bedside clinical assessments. However, with the introduction of new diagnostic and respiratory technologies, our ability to support critically ill infants with acute viral bronchiolitis will continue to advance. | James A Lin Andranik Madikians | 2015 | World Journal of Critical Care Medicine2015，4，3： | 1 |
| 5 | 羟乙基淀粉130/0.4和高渗氯化钠羟乙基淀粉40联合扩容在肝癌切除术中的应用显示文摘目的探讨在肝癌手术中联合使用羟乙基淀粉130/0.4注射液(Voluven)或高渗氯化钠羟乙基淀粉40注射液(HSH40)扩容对患者血压、凝血酶原时间(PT)的影响及节约异体输血的安全性和有效性。方法将择期行肝癌切除术的60例患者随机分为HSH40联合乳酸钠林格液组(HR组)以及HSH40联合Voluven组(HV组)各30例。HR组麻醉诱导前静脉滴注HSH40,术中予乳酸钠林格液维持中心静脉压;HV组麻醉诱导前静脉滴注HSH40,术中辅助使用Voluven液维持中心静脉压。记录和比较两组患者总失血量、输液量、需输血例数、尿量、手术时间以及术前和术毕的平均动脉压(MAP)、PT和钠离子浓度。结果两组的总失血量、手术时间比较差异无统计学意义(P>0.05)。HV组的输液量、需输血例数均少于HR组(P<0.05)。HV组的尿量多于HR组(P<0.05)。两组MAP、PT及钠离子浓度的术前术后及组间比较差异均无统计学意义(P>0.05)。结论肝癌切除术中联合应用Voluven和HSH40可安全有效地增加循环储备,减少红细胞丢失,增强患者对于失血的耐受力,减少异体血的输注量,起到有效的血液保护作用。 | 任柏林 杨清存 | 2014 | 新医学2014，45，3： | 1 |
| 6 | Inhaled hypertonic saline for cystic fibrosis: Reviewing the potential evidence for modulation of neutrophil signalling and function显示文摘Cystic fibrosis(CF) is a multisystem disorder with significantly shortened life expectancy. The major cause of mortality and morbidity is lung disease with increasing pulmonary exacerbations and decline in lung function predicting significantly poorer outcomes. The pathogenesis of lung disease in CF is characterised in part by decreased airway surface liquid volume and subsequent failure of normal mucociliary clearance. This leads to accumulation of viscous mucus in the CF airway, providing an ideal environment for bacterial pathogens to grow and colonise, propagating airway inflammation in CF. The use of nebulised hypertonic saline(HTS) treatments has been shown to improve mucus clearance in CF and impact positively upon exacerbations, quality of life, and lung function. Several mechanisms of HTS likely improve outcome, resulting in clinically relevant enhancement in disease parameters related to increase in mucociliary clearance. There is increasing evidence to suggest that HTS is also beneficial through its anti-inflammatory properties and its ability to reduce bacterial activity and biofilm formation. This review will first describe the use of HTS in treatment of CF focusing on its efficacy and tolerability. The emphasis will then change to the potential benefits of aerosolized HTS for the attenuation of receptor mediated neutrophil functions, including down-regulation of oxidative burst activity, adhesion molecule expression, and the suppression of neutrophil degranulation of proteolytic enzymes. | Emer P Reeves Cormac McCarthy Oliver J McElvaney Maya Sakthi N Vijayan Michelle M White Danielle M Dunlea Kerstin Pohl Noreen Lacey Noel G McElvaney | 2015 | World Journal of Critical Care Medicine2015，4，3： | 0 |
| 7 | Effect of hypertonic saline/dextran 70 on cardiac function in delayed resuscitation of dogs with burn shock显示文摘To investigate the effect of hypertonic saline / dextran 70 (HSD) on cardiac function in delayed resuscitation of burn shock. Methods: HSD was used for resuscitation 6 h postburn in dogs and its effect on cardiac function was evaluated byvolume load,MAP, LVSP,LVEDP, + dp/dtmax, -dp/dtmax, CO and SVR. Results: The volume of HSD was 30.50% less duringfirst 24 h postburn and 59.50% less during 4 h after resuscitation than that of lactated Ringer’s solution (LR’s). MAP, LVSP,LVEDP, + dp/dtmax, -dp/dtmax and CO increased and SVR reduced in HSD resuscitation. Conclnsion: Smaller volume of HSD canexpand plasma volume significantly and improve cardiac function in delayed resuscitation of burn shock. | 王德伟 朱世辉 刘世康 孙曙光 毛智生 陈玉林 葛绳德 | 1998 | Journal of Medical Colleges of PLA(China)1998，13，1： | 0 |
| 8 | Blood flow variation and energy metabolism in the gastric mucosa following 7.5% hypertonic saline resuscitation显示文摘Bloodflowvariationandenergymetabolisminthegastricmucosafollowing7.5%hypertonicsalineresuscitationWangJunyi(王俊义);WuGuosheng;(吴... | 王俊义 吴国生 陈冬利 | 1996 | Journal of Medical Colleges of PLA(China)1996，11，3： | 0 |
| 9 | A study of therapeutic effects of 7.5% NaCl-6% dextran 70 in small dosage on hemorrhagic shock at high altitude in dogs显示文摘The effects of 7.5% NaCl-6% dextran 70 in small dosage on the cardiovascular func-tion and the survival rate in hemorrhagic shock at a simnlated altitude of 4000 m were observedin dogs.The animals were bled from the femoral artery for 8 rain to reduce the mean arterialpressure to 5.73±0.1kPa,which was maintained for an hour.Then the dogs were intravenouslyinjected with 4ml/kg 0.9% NaCL(NS group,n=7),7.5% NaCl(HS group,n=6)and 7.5%Naa-6% dextran 70(HSD group,n=6)respectively.In the 2-hour-period after injection,5out of 7 dogs of NS group died but only 1 out of the 6 of both the HS and HSD groupsdied.Significant increase of mean arterial pressure,left ventricular pressure,±dp/dt max of leftventricle,cardiac output,cardiac index and cardiac minute work index was observed in both theHS and HSD groups.Improvement of the cardiovascular function was even more marked inHSD group than in HS group,thougth the difference between the 2 groups was statisticallyinsignificant.There was a tendency for the pulmonary vascular resistance to decrease in HS andHSD groups as compared with the NS group.The percentage of plasma expansion of HSDgroup was larger than that of HS group(P<0.05)and of NS group(P<0.01),but nosignificant difference existed between the HS and NS groups.It is believed that intravenous injection of hypertonic saline alone or in combination with dextran is effective for the treatment ofhemorrhagic shock at high altitude and the combination of 7.5% NaCl and 6% dextran 70seems even more effective. | 高钰琪 周勇敬 罗德成 王俊元 王强 邓学才 | 1992 | Journal of Medical Colleges of PLA(China)1992，7，2： | 0 |
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