Influence of Various Types of Start Infusion Therapy on Pre-Load Values in Patients with Infectious Toxic Shock

Ye.V. Ivakhnenko

Abstract


The main purposes of shock infusion therapy should be achievement of euvolemia and hemodynamic stabilization, correction of acid-base balance, rehydration of interstitial and intracellular sectors, maintenance of adequate gradient between colloid osmotic plasma pressure and pulmonary capillary wedge pressure, improvement of microvascular blood flow, prevention of cascade mechanisms activation and hypercoagulation, normalization of oxygen delivery to tissues. The aim of this study is to investigate reaction of hemodynamics parameters to various types of infusion therapy. The paper analyses and resumes the results of observation and treatment of 111 patients with different forms of severe infectious pathology. Depen­ding on start infusion solution the patients were divided into 4 groups. The results of the study allow conclude that hemodynamic profile of the patient needed for rehydration could be considered as a hypodynamic one. Chloride sodium hypertonic solutions do not significantly enhance central venous pressure but increase pre-load, due to these properties their combination with dextran allows decrease pulmonary vascular resistance, so that improve pre-load at lower parameters of pressure in pulmonary artery. Resuscitation with 6% solution of НАЕ8 200/10% NaCl is associated with greater pulmonary vascular resistance that does not impede improving left ventricle pre-load.


Keywords


infectious toxic shock; infusion therapy; pre-load

References


Rhee, Peter, et al. "Human neutrophil activation and increased adhesion by various resuscitation fluids." Critical care medicine 28.1 (2000): 74-78.

Ciesla, David J., et al. "Hypertonic saline attenuation of polymorphonuclear neutrophil cytotoxicity: timing is everything." Journal of Trauma-Injury, Infection, and Critical Care 48.3 (2000): 388-395.

Rizoli, Sandro B., et al. "Immunomodulatory effects of hypertonic resuscitation on the development of lung inflammation following hemorrhagic shock." The Journal of Immunology 161.11 (1998): 6288-6296.

Suzuki, K., T. Ajito, and S. Iwabuchi. "Effect of infusion of hypertonic saline solution of conscious heifers with hypoxemia caused by endotoxin infusion." American journal of veterinary research 59.4 (1998): 452-457.

Yunher V. Sposobnost' hypertonycheskoho rastvora natryya khloryda povыshat' ymmunnыe funktsyy kletky. // Sepsys. — Kyev: Nora-Prynt. — 1997. — S. 53.

Junger, W. G., Coimbra, R., Liu, F. C., Herdon-Remelius, C., Junger, W., Junger, H., ... & Altman, A. (1997). Hypertonic saline resuscitation: a tool to modulate immune function in trauma patients?. Shock, 8(4), 235-241.




DOI: https://doi.org/10.22141/2224-0586.6.69.2015.78685

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2017

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru