I read before about using 3% saline in initial fluid resucitacion, but beber used it as hypernatremia aún hyperosmolality could happen. Does anyone have info that can share about this approach un particular?
El 24/04/2013, a las 02:01, "Thomas Morris" <[email protected]> escribió: > What did that do to the renal function?! > > > On Tue, 23 Apr 2013 21:33:34 -0400 > Rich Levrault <[email protected]> wrote: >> As a fellow I presented a lit review on the use of hypertonic saline in >> resuscitation in sepsis and some interesting effects on cytokines and >> cellular adhesion molecules were noted(positive effects). I haven't looked >> at those data in a while but wanted to throw it out to the group. I was >> feeling a bit salty. Sent from Rich's iPhone >> On Apr 22, 2013, at 7:56 AM, "Thomas Morris" <[email protected]> >> wrote: >>> Hi Jeffrey >>> Thanks - although the Traumatic Brain Injury paper had patients on only >>> 10hrly litre bags of NS for 48 hours, which is max. 4.8 litres - not that >>> much is it? Surely you still have to "fill the gap" before, or at the same >>> time as, getting someone on pressors? >>> I think it's a bit of a clinical evidence "hole" though, and personally I'm >>> planning to use NS for the first 2 litres, then a bag of 5% dextrose (or >>> possibly D/saline) for the 3rd litre, then flip a coin for what to give >>> after that! Ie. crystalloid on one side, gelatin-based on the other! Or >>> blood. No starch! And bring on the research for adjunctive immate immune >>> system modulatory therapies. >>> Tom Morris >>> Infectious Disease/GIM Registrar >>> On Sat, 20 Apr 2013 19:43:25 -0400 (EDT) >>> that <[email protected]> wrote: >>>> All of this must be taken in context of which bundle you are working in. >>>> Being an ED nurse, our main focus is in the resuscitation bundle and NSS >>>> is the fluid of choice. We have, on occasion, given albumin but that seems >>>> to be practitioner dependent. Plasma and PRBC's are next on the list, >>>> especially if your HCT is low. If you stick to EGDT and get your patient >>>> on pressors appropriately and start your broad spectrum antibiotics in a >>>> timely manner you probably won't have to worry about the hyperchloremic >>>> acidosis. If not it won't matter because the elevated lactate will get you >>>> to organ failure and death long before you need to worry about >>>> hyperchloremia. >>>> Just my opinion. Jeffrey R Hanlon RN >>>> Stamp Out Sepsis >>>> -----Original Message----- >>>> From: Katzaman, Alecia <[email protected]> >>>> To: '[email protected]' >>>> <[email protected]> >>>> Sent: Tue, Apr 16, 2013 8:40 am >>>> Subject: [Sepsis Groups] NSS vs Albumin >>>> What does everyone do in terms of fluid resuscitation – do you give NSS or >>>> Albumin? What do you do in the ED? DO you have a limit of NSS that is >>>> given before Albumin is given, or is provider specific? >>>> Alecia Katzaman, MSN, RN >>>> Emergency Department Quality Improvement Coordinator >>>> P.O. Box 16052 >>>> Reading, PA 19612-6052 >>>> [email protected] >>>> www.readinghealth.org >>>> PHONE: 484-628-4810 >>>> Advancing Health. Transforming Lives. >>>> ----- Email Disclaimer ----- >>>> This email and any files transmitted with it are confidential and are >>>> intended for the named recipient(s). If you are not the intended >>>> recipient, you are hereby notified that you have received this >>>> communication in error and that any copying, disclosure, dissemination, >>>> distribution or review of it or its contents is prohibited. If you have >>>> received this email in error, please notify the sender and immediately >>>> delete this email from your system. >>>> --------------------------------------- >>>> _______________________________________________ >>>> Sepsisgroups mailing list >>>> [email protected] >>>> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >>> _______________________________________________ >>> Sepsisgroups mailing list >>> [email protected] >>> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
