Is there any guidance on what percent Albumin should be used for Resuscitation, ?
Amer Raza, MD Pulmonary/Critical Care Mercy Health Systems [email protected] > From: [email protected] > Subject: Sepsisgroups Digest, Vol 82, Issue 3 > To: [email protected] > Date: Tue, 5 Nov 2013 12:07:22 -0800 > > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: Sepsisgroups Digest, Vol 82, Issue 2 (Louis Landman) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Mon, 4 Nov 2013 17:57:44 -0500 > From: "Louis Landman" <[email protected]> > To: <[email protected]> > Subject: Re: [Sepsis Groups] Sepsisgroups Digest, Vol 82, Issue 2 > Message-ID: <FCDF60BCD6554B10A15D91779512EF3A@Sony> > Content-Type: text/plain; format=flowed; charset="iso-8859-1"; > reply-type=original > > I'm glad we're not the only ones with woefully slow pumps! We make up for > it by using 2 or 3 infusion sites; for instance, 999 m/hr in each arm and > through a central line, so about 1L every 20 minutes. > > Louis Landman, MD > > -----Original Message----- > From: [email protected] > Sent: Monday, November 04, 2013 5:50 PM > To: [email protected] > Subject: Sepsisgroups Digest, Vol 82, Issue 2 > > Send Sepsisgroups mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of Sepsisgroups digest..." > > > Today's Topics: > > 1. Re: Initial Fluid Bolus (Hawkins, Denis) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Mon, 4 Nov 2013 22:50:17 +0000 > From: "Hawkins, Denis" <[email protected]> > To: "'[email protected]'" > <[email protected]>, "'[email protected]'" > <[email protected]> > Cc: "'[email protected]'" <[email protected]>, "'[email protected]'" > <[email protected]>, "'[email protected]'" > <[email protected]>, "'[email protected]'" > <[email protected]>, "'[email protected]'" <[email protected]>, > "'[email protected]'" <[email protected]> > Subject: Re: [Sepsis Groups] Initial Fluid Bolus > Message-ID: > <1d03c7f613bcdd4eac466f6a435ddf2b013dc...@smesexcp014031.msnyuhealth.org> > > Content-Type: text/plain; charset="utf-8" > > Anyone have a good article to use as evidence for initial fluid bolus? > > From: Hesham Hassaballa [mailto:[email protected]] > Sent: Sunday, November 03, 2013 03:32 PM > To: Kramer, George C. <[email protected]> > Cc: Mileski, William <[email protected]>; > [email protected] <[email protected]>; > Tillman, Melinda A. <[email protected]>; Pacheco, Luis D. > <[email protected]>; Whitehead, William E. <[email protected]>; Kinsky, > Michael P. <[email protected]> > Subject: Re: [Sepsis Groups] Initial Fluid Bolus > > I completely agree with George. 999 mL/hr is WAY too slow. The problem is > the pumps can't go any faster, and many times the patients have poor IV > lines that can't take pressure bag boluses ( because many times we are > putting in the central line) > > > > Hesham A. Hassaballa, MD > Program Medical Director > Critical Care > Rush-Copley Medical Center > 2000 Ogden Avenue > Aurora, IL 60504 > Phone: (331) 454-6572 > > ### CONFIDENTIALITY NOTICE ### > This message and any included attachments are from Cogent HMG and are > intended only for the addressee. The contents in this message contain > confidential information belonging to the sender that is legally protected. > Unauthorized forwarding, printing, copying, distribution, or use of such > information is strictly prohibited and may be unlawful. If you are not the > addressee, please promptly delete this message and notify the sender of the > delivery error by e-mail or contact the Cogent HMG Privacy Officer at > [email protected]<mailto:[email protected]>. > > On Nov 3, 2013, at 8:08 AM, "Kramer, George C." > <[email protected]<mailto:[email protected]>> wrote: > > Phil and Terry, > > Am I off base here? > > To me, and the clinicians at our institution, it is often not so much the > volume, but the rate of infusion and how promptly to deliver the volume that > is the controversy. And there is a very active debate at our institution on > this. > > I suggest that 999 ml/kg is largely an inadequate rate. Our surgical > intensivists totally support boluses administered by pressure bag and at a > minimum wide open going in fast. > > However, many of our medical intensivists and nurses seem to believe that > 999 ml/hr is acceptable and even ideal. It makes sense to me that sometimes > 999 is ok, sometimes, > > but often it is inadequate and puts the patient at risk for remaining in a > state of hypo perfusion. And even if fluid overload is a concern rapid > bolus, with assessment after each is in order in septic shock and severe > sepsis. > > g > > George Kramer, PhD > UTMB > > OvidSP > Results<message:%[email protected]%3E> > From: <Dellinger>, Phil > <[email protected]<mailto:[email protected]>> > Date: Monday, October 28, 2013 10:54 AM > To: Hesham Hassaballa > <[email protected]<mailto:[email protected]>>, > "[email protected]<mailto:[email protected]>" > > <[email protected]<mailto:[email protected]>> > Subject: Re: [Sepsis Groups] Initial Fluid Bolus > > Probably the best thing to do. And definitely simpler than trying to figure > out a more precise fluid load estimate. I addressed this issue with the > primary investigators and research coordinators for the EUPHRATES trial(for > which I am the PI for the international trial). We are looking at endotoxin > removal with hemoperfusion in patients with septic shock identified to have > high endotoxin activity. One of the entry criteria, which also includes a > certain level of vasopressor support, is 30 ml/kg actual body weight of > crystalloid(or colloid equivalent) fluid resuscitation. > > ?From a purist standpoint, fluid bolus in obese septic shock patients should > be somewhat less per kg than in someone who is normal body habitus since the > intravascular volume expands at a somewhat lower % as body weight increases > in the obese patient. However no one has ever used, in septic shock research > trials, formulas that are available but not well validated to adjust for > blood volume in the obese patient..? > > > From: > [email protected]<mailto:[email protected]> > > [mailto:[email protected]] On Behalf Of Hesham > Hassaballa > Sent: Friday, October 25, 2013 9:33 AM > To: > [email protected]<mailto:[email protected]> > Subject: [Sepsis Groups] Initial Fluid Bolus > > I'm using actual body weight, and it works out very well. I think if we use > ideal body weight, it will under resuscitate the patient. > > Hesham A. Hassaballa, MD > Program Medical Director > Critical Care > Rush-Copley Medical Center > 2000 Ogden Avenue > Aurora, IL 60504 > Phone: (331) 454-6572 > > ### CONFIDENTIALITY NOTICE ### > This message and any included attachments are from Cogent HMG and are > intended only for the addressee. The contents in this message contain > confidential information belonging to the sender that is legally protected. > Unauthorized forwarding, printing, copying, distribution, or use of such > information is strictly prohibited and may be unlawful. If you are not the > addressee, please promptly delete this message and notify the sender of the > delivery error by e-mail or contact the Cogent HMG Privacy Officer at > [email protected]<mailto:[email protected]>. > > ### CONFIDENTIALITY NOTICE ### > > This message and any included attachments are from Cogent HMG and are > intended only for the addressee. The contents in this message contain > confidential information belonging to the sender that is legally protected. > Unauthorized forwarding, printing, copying, distribution, or use of such > information is strictly prohibited and may be unlawful. If you are not the > addressee, please promptly delete this message and notify the sender of the > delivery error by e-mail or contact the Cogent HMG Privacy Officer at > [email protected]<mailto:[email protected]>. ?? > > **************************************************************** This > communication, including attachments, may contain information that is > confidential. It constitutes non-public information intended to be conveyed > only to the designated recipient(s). If the reader or recipient of this > communication is not the intended recipient, employee, or agent of the > intended recipient who is responsible for delivering it to the intended > recipient, or you believe that you have received this communication in > error, please notify the sender immediately by return e-mail or telephone > and promptly delete this e-mail, including attachments without reading them > or saving them in any manner. The unauthorized use, dissemination, > distribution, or reproduction of this e-mail, including attachments, is > prohibited and may be unlawful. > > ### CONFIDENTIALITY NOTICE ### > > This message and any included attachments are from Cogent HMG and are > intended only for the addressee. The contents in this message contain > confidential information belonging to the sender that is legally protected. > Unauthorized forwarding, printing, copying, distribution, or use of such > information is strictly prohibited and may be unlawful. If you are not the > addressee, please promptly delete this message and notify the sender of the > delivery error by e-mail or contact the Cogent HMG Privacy Officer at > [email protected]. ?? > -------------- next part -------------- > An HTML attachment was scrubbed... > URL: > <http://lists.sepsisgroups.org/pipermail/sepsisgroups-sepsisgroups.org/attachments/20131104/af628d2f/attachment.htm> > > ------------------------------ > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > End of Sepsisgroups Digest, Vol 82, Issue 2 > ******************************************* > > > > ------------------------------ > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > > > End of Sepsisgroups Digest, Vol 82, Issue 3 > *******************************************
_______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
