جستجوی مقالات مرتبط با کلیدواژه « مایع درمانی » در نشریات گروه « پزشکی »

Intraoperative fluid therapy is to ensure adequate injection of maintenance fluids including electrolytes and glucose to replace fluid deficiency during surgery. Given that there is still no consensus on fluid therapy in neonates, the aim of this study was to evaluate the use of normal saline serum and one fifth-four fifths serum in neonates who are candidates for surgery. 

In a randomized clinical trial study, 72 neonates who were 1- 30-days-old and candidates for surgery, admitted to Imam Hossein Hospital in Isfahan were divided into two groups. Fluid therapy was randomly administered using normal saline or one-fifth-four-fifths fluid in each group. Biochemical and hemodynamic variables such as blood sugar, sodium, pH, bicarbonate BE, heart rate and mean arterial pressure were assessed preoperatively and postoperatively.

Post-operative blood glucose levels after 60-minutes at The Neonatal Intensive Care Unit (NICU) for the normal saline group were 152.56, 148.47 and 155.61 mg/dl, respectively, while in one fifth–four fifths solution group were 242.78, 197.28, 278.19 mg / dl, respectively, which showed a significant difference between the two types of solutions. There was also a significant increase in blood sugar compared to pre-operative states. Mean pre-operative plasma sodium levels showed a significant increase for the normal saline group and a significant decrease for the one fifth-four fifth group.

One fifth- four fifths solution owing to hyperglycemia and hyponatremia is not a suitable choice for intraoperative fluid therapy in neonates. In contrast, normal saline solution performed better in controlling blood sugar and plasma sodium.

Oligohydramnios (amniotic fluid depletion) is a common problem in pregnancy that is associated with several complications. In addition to managing the underlying cause, treatment measures are necessary to reduce its consequences. The aim of the present clinical trial study was to compare the effect of L-arginine and fluid therapy alone on oligohydramnios.

In the present clinical trial study conducted in Fatemieh Hospital affiliated to Hamadan University of Medical Sciences in 2020, fifty pregnant women with 28 to 36 weeks gestation, with singleton pregnancy with Amniotic Fluid Index (AFI) less than 8 cm evenly were selected and randomly divided into two intervention groups, L-arginine at a dose of 3 g twice daily with fluid therapy (3 liters of lactated ringer in 24 hours) and the control group given fluid therapy alone between 1 to 4 weeks based on gestational age and AFI. Changes in amniotic fluid volume before and after the intervention and pregnancy outcomes were assessed and compared in the two groups. Data were analyzed using independent t-test, paired t-test and chi-square.

After the intervention, the mean AFI increased to 5.44 ± 0.86 in the control group and 85.28 ± 1.51 in the interventional group (P=0.001). The mean AFI in both groups showed a significant increase compared to the previous intervention. The mean gestational age in the interventional group at the end of the study compared to the fluid therapy group indicated a significant increase (35.24 ± 0.71 vs. 36.72 ± 0.59 cm). The mean Apgar score in the first minute and 5 in the interventional group was significantly higher. Other outcomes were comparable in the two groups.

In women with oligohydramnios, the use of L-arginine in combination with injectable fluid therapy with increased volume of amniotic fluid can be associated with better outcomes.

Postdural puncture headache is a complication of spinal block in postpartum period, which increases the cost of hospitalization and limits maternal activity. The purpose of this study was to evaluate the role of intravenous fluid therapy before the onset of spinal block in the incidence, severity and duration of postdural puncture headache.

The present study was a clinical trial. The statistical population consisted of two groups of 75 women candidates for elective cesarean section in Rafsanjan in 2018. In the pre-partum room, 500 CC ringer serum was infused into the intervention group and the control group did not receive any serum. The two groups were compared for post dura puncture headache during 7 days via independent two-sample t-test and chi-square test.

The results showed that intravenous fluid therapy before entering the operating room in women undergoing elective cesarean section can significantly reduce the incidence of postdural headache in the same technical conditions ( 2 persons equal 2.7% of intervention group versus 12 persons equal 16% of control group) (p=0.005). Although, there were no significant differences between the two groups in some indices (p>0.05), indices such as headache severity, frequency of acetaminophen need and number of its use in the intervention group were less than the control group.

The results showed that intravenous serum therapy prior to spinal anesthesia in cesarean section for at least eight hours fasting could significantly reduce the incidence of postdural headache in subsequent days. So, this simple and accessible action can be helpful.

Acute diarrhea is one of the most important health issues in developing countries. Yogurt drink (Dough) is used in home remedies and some medical advice as a useful ingredient in treating dehydration and diarrhea; but no controlled studies have been conducted in this regard. The aim of this study was to compare the effect of fluid therapy along with dough or yogurt in the treatment of acute diarrhea in children.

In this randomized clinical trial study, 210 children aged 1-5 years with acute diarrhea, who were admitted to Taleghani hospital in Gorgan, Iran, were entered. The first group received low-fat yogurt, and the second group received dough, which the volume was three times the volume of yogurt in the first group. The third group was control group. Standard fluid therapy groups had done for all patients. Decrease in diarrhea frequency and hospitalization in these three groups were compared.

The highest reduction in diarrhea was in yogurt group with an average of 6.144, and the lowest in dough group with a mean of 5.344 (P = 0.108). After controlling the effect of the severity of the disease, the dough-receiving group had the longest hospitalization time, and this difference was significant.

The results of this study showed that the use of dough and yogurt, along with fluid therapy, did not reduce the frequency of acute diarrhea and duration of admission in children under five years of age. Further research with higher sample sizes and the implicating probiotic drinks along with dough seems necessary. Due to the small number of studies in this issue and the result of the present study, at present dough cannot be recommended as an effective agent in the treatment of diarrhea.

Aim :

This study aimed at examining the effect of preoperative fluid therapy on kidney function in patients undergoing heart surgery.

Background:

 As one of surgery complications, kidney failure occurs with oliguria and rise in creatinine. Decreased heart output leads to reduction in renal perfusion. Acute renal failure is associated with increase in morbidity, mortality and high medical treatment cost. Various studies has indicated an increase in postoperative mortality rate when complications of acute renal failure superimpose the situation. One of the best strategies for kidney protection is optimizing preoperative hemodynamics and fluid therapy.

Method:

 In this clinical trial study, 107 patients were recruited based on inclusion criteria and randomly allocated to experimental (n=54) and control (n=53) group. Patients in experimental group received Half- Saline, 1cc/kg/hr, during 12 hours before surgery. Patients in control group started as being NPO, 8 hours before the surgery. Creatinine level, BUN, and 24-hours urine output were measured and recorded during two days after surgery. Data were analyzed in SPSS V.22 using descriptive and inferential statistics.

Findings:

The groups didnchr('39')t differ in terms of age, gender, weight, and ejection fraction. There was no statistically significant difference between experimental and control group in terms of creatinine changes during the preoperative day and the first and the second day after surgery. Also, there was no statistically significant difference between groups in BUN on the first and second days after surgery. The urine output of the experimental group was greater than control group on first and second days after operation, but the difference was not significant. The duration of ICU stay were similar in both groups. There were recorded two deaths in control group while there was no death in experimental group.

Conclusion:

It was concluded that preoperative fluid therapy has no short-term effect on kidney function. It is recommended to examine the effect of fluid therapy on kidney function in longer periods.

Colonoscopy is a valuable diagnostic method that patients are not willing to undergo because of the fear of its complications. The purpose of this study was to determine the effect of intravenous fluid therapy prior to colonoscopy on blood circulation parameters and pain in patients and duration of Colonoscopy. This randomized clinical trial was conducted on 60 patients referred to the Endoscopic Department of Ghaem Hospital in Mashhad in 2016. Elderly people were randomly assigned to two groups of 30 as control and intervention groups. Patients in the intervention group received one liter of solution 1/3 normal saline, 2/3 D5W, one hour before colonoscopy. Before and 1, 3, 5, 9, and 10 minutes after colonoscopy, arterial blood oxygen saturation, heart rate, and blood pressure in both groups were measured and recorded in the checklist. 2 hours later, the patients’ pain levels were measured by Circulation Parameters checklist. The numerical value of pain was measured, and the durations of colonoscopy in both groups were also measured and recorded by a timer. The mean age of the patients in the intervention group was 38.4 ± 13.6 years and in the control group was 44.2 ± 14.4 years. The results of post start colonoscopy stage showed that there was a significant difference between the two groups in the mean arterial oxygen saturation after 5 and 9 minutes of fluid therapy (p < 0.001), systolic blood pressure 1 and 10 minutes after fluid therapy (p = 0.047), and diastolic blood pressure 5 minutes after the fluid therapy (p = 0.049). The mean duration of colonoscopy in the intervention group (18.15 ± 4.21 min) was significantly lower than the control group (22.13 ± 5.29 min, p = 0.002). Also, the mean pain score 2 hours after colonoscopy was significantly lower in the intervention group (1.53 ± 1.65) compared with the control group (3.26 ± 3.24, p = 0.010). The results of this study indicate the positive effect of fluid therapy prior to the onset of colonoscopy on the patients’ circulatory parameters, the duration of colonoscopy, and the patients’ pain. Therefore, with this effective, cost-effective, and safe intervention, patients can have a better experience in performing this diagnostic test.

Various fluids such as saline, hypertonic saline, and serum colloid are used to compensate the body lost fluids after head trauma. The aim of this study was to determine the effects of various solutions on vital signs, serum electrolytes and acid-base status in patients with head trauma.
This cross-sectional study was done in Alzahra hospital, Isfahan University of Medical Sciences, Iran. 340 hospital records of patients with head trauma were studied and hemodynamic parameters, blood gases and electrolytes were analyzed based on the osmolarity status. The data were analyzed using chi-square and one-way and repeated-measures analysis of variance (ANOVA) tests.
Findings: During hospitalization in intensive care unit (ICU), 74 patients (21.8%) died. Need to ventilation was different based on the kind of fluid and the percent of ventilation in hyperosmolar group (48.8%) was lower significantly than the iso- (64.4%) and hypo-osmolar (56.4%) groups (P = 0.042). The mortality rate was significantly higher in iso-osmolar group (37.8%) compared to hypo- (17.9%) and hyperosmolar (15.6%) groups (P Using hyperosmolar solutions in patients with head trauma led to more favorable hemodynamic stability and electrolyte status and lower mortality rates in these patients. So, using hyperosmolar solutions, if there is no contraindication, is preferred to hypo- and iso-smolar solutions and is recommended.

In cases of acute Appendicitis with vague symptoms، the diagnosis maybe delayed and during this interval، most patients receive fluid therapy. Az a result the patients'' symptoms declines and even sometimes they refuse to operate. The purpose of this study was evaluation of effect of fluid therapy on symptoms and signs of acute appendicitis. In a prospective comparative clinical trial study 130 patients were studied. Patients in two groups of 65 people who qualified were studied In one group 6 hours before the surgery fluid therapy had been done and in the other group no medications or fluids were prescribed and information recorded. Finally 6 hours after the admission، patients were operated and pathological records collected. Data classified and analyzed by SPSS software and P value of more than 0. 05 considered valuable. Based on our data، the abdominal pain، the most important sign of appendicitis، decreased meaningfully in the fluid therapy group in comparison with non rehydrated group. (p= 0. 0001). The anorexia changes (improving appetite)، reducing the tenderness and rebound tenderness were obviously different in two groups (p>0. 05). These results mean that fluid therapy has effect on signs and symptoms of appendicitis. This may result in delay or misdiagnosis of appendicitis. Thus the physician should be aware، especially in patients that have received fluid therapy. Although، we could not find any physiopathologic reason for this effect.

Clinical vasospasm following subarachnoid hemorrhage is one of the most important causes of mortality during first two weeks after subarachnoid hemorrhage. Thus, some investigations have been conducted to evaluate the efficacy of triple-H accompanied with other drugs, such as calcium blocker, and early operation. In addition, colloid solutions such as albumin have also been used in treatment of hypervolemia. However, no study has compared different liquids. The aim of this study was to evaluate the efficacy of Voluven vs. albumin infusion (as hyper volume therapy) in prevention and treatment of clinical vasospasm following subarachnoid hemorrhage. This double-blind clinical trial that was performed in Alzahra Hospital, Isfahan, Iran, in 2011. We studied 64 patients with aneurysm, subarachnoid hemorrhage who referred to the hospital. The patients were divided into two groups. Early surgery was performed whenever possible and hypertensive hypervolemic hemodilution therapy was instituted with the first sign of clinical vasospasm. The first group was treated by albumin and the second group by Voluven liquids. Both groups were followed-up for 2 weeks. Glasgow Coma Scale (GCS) and Hunt-Hess Grade (HHG) were used for daily assessments of neurologic status, neurologic deficit, and hemodynamic status of the patients. Finally, the collected data was analyzed by SPSS. According to the results of this study, no statistically significant differences in the trend of GCS and HHG were observed between the two groups during follow-up (P > 0.05). There were not any significant differences between the two groups in terms of treatment results and complications. However, Voluven is cheaper than albumin. Therefore, Voluven can be efficiently used for prevention and treatment of clinical vasospasm following subarachnoid hemorrhage.

PONV is a common complication after ENT surgeries (37-42%). Common drugs used for PONV prevention have different side effects. In recent studies preoperative fluid therapy has known as an effective method for PONV prevention. In this double blind RCT 97 patients undergoing Tympanomastoidectomy surgery have assessed for incidence and severity of PONV and postoperative pain (POP) in 3 groups. Patients received 3 doses of ringer solution during anesthesia: 4cc/kg (G4, n=30), 10cc/kg (G10, n=33), 20cc/kg (G20, n=34) Patients in 3 groups was identical in mean age, mean weight, sex, anesthesia duration and anesthetic management. Incidence and severity of nausea and POP in G4 was significantly greater comparing with two other groups in a dose dependent manner. Only 3 cases had vomiting in G4 and not in two groups. Sore throat and dizziness in G4 were more than other groups but were not statistically significant. So because of more efficacy of 20cc/kg ringer solution to PONV and POP prevention than lower doses in patients undergoing Tympanomastoidectomy surgery and cost effectiveness and safety of this method, we propose this as a routine method in PONV and POP prevention in ASAΙ patients in moderate lasting surgeries (≈2һ)

Nausea and vomiting is common post operative complications that often necessitate the use of antiemetic agent sand it is still a problem. This study evaluated the effect of additional fluid therapy on PONV on patients undergoing Shirodkar’s operation. In a randomized, double blind Trail, the effect of pre operative moderate fluid administration on post operative nausea and vomiting (PONV) following anesthesia was studied. One hundred twenty women undergoing shirodkar surgery was randomly assigned to receive Npo fluid (control group) or Npo fluid plus 10 ml.kg (moderate hydration group) of ringer solution pere operation. During recovery time and in the ward nausea and vomiting were evaluated. Groups were similar with respect to demographic data, surgical procedures and baseline homodynamic variables. During the recovery room and in the ward, the incidence of nausea and vomiting were significantly lower in the hydrated group as compared with control (p<0.05). The present study showed that moderate hydration reduces the incidence of post shirodkar surgery nausea and vomiting, and seem that IV fluid therapy is a simple, effective, safe and well-tolerated technique for prevention of postoperative nausea and vomiting

Acute renal failure (ARF) is defined as an abrupt severe decrease in glomerular filtration rate (GFR). ARF is commonly seen in neonates admitted to neonatal intensive care unit. In this article, we have studied incidence, etiology, predisposing factors, management and mortality in neonates affected by ARF. A descriptive study was took placed at NICU of Qhaem hospital over a period of one year, between December 2005 and December 2006. 750 neonates were evaluated for ARF, according to having two of three following criteria: 1- oliguria: U/A < 1/2cc/kg/h 2- BUN> 20 mg/dl 3- Cr>1/2 mg/dl Patients were assessed for B.S (blood sugar), BUN, Cr, urine index (FENa, Uosm, BUN/cr, U/P osm, RFI, Una), ABG and kidney sonography. According to patient’s response to the fluid therapy and kidney sonography, they were divided into two pre-renal and renal failure groups. Data were analyzed using descriptive statistics. From 750 neonates admitted in NICU, 38 patients (%5) demonstrated ARF. Pre-renal failure was found in 29 newborns (%76/4) and 9 neonates (%23/6). Predisposing factors for ARF were as following: Asphyxia (%42), Respiratory distress syndrome (RDS) (%26/7), sepsis (%13), sever dehydration (%13) and congenital heart disease (CHD) (%5). Nine infants (%23/6) were died. Mortality was significantly higher in intrinsic renal failure (%88). ARF is still an important etiology of mortality in newborns. Diagnosis of predisposing factors (prematurity, asphyxia, RDS, ventilation and careful kidney control in newborn is essential in this problem.

Backgrond & Oligohydramnios is a disorder which is followed by unpleasant outcomes for fetus that can lead to termination of pregnancy before term and preterm delivery. For these patient's increase in gestational period and prevention of preterm delivery is the most important act. In this study the effect of intravenous and oral hydration therapy in increasing duration of gestation in patient with oligohydramnios was evaluated. In this study, the population was devided into two case and control groups with 30 female individual who were found to have oligohydramnios in course of hospital admission according to on sonographic results. Patients were randomly put in case or control groups. Case group were given 3-4 liter normal salin for 1 week and then were given oral hydration solution until the end of pregnancy, In each group whenever it was found that pregnancy was not possible the pregnancy continuance was stopped. Data collection was through history, physical examination completing relevant questionnaire and findings of sonography and in order to see the relationship among finding s, kitest and t-test from SPSS software were used. The age means of case and control groups were 25 and 24 respectively. The mean of pregnancy duration from the diagnosis time in case group was 30.2 weeks and in control group 31.8 weeks. The mean of pregnancy terminatior in case group was 34.6 weeks and in control group 34.2. In increasing duration of pregnancy in case and control group. It was concluded that intravenous and oral Hydration therapy cause incerease in duration of pregnancy in patients suffering from oligo Hydraminos. According to the results of this study and significance of the difference.

Recent studies have demonstrated that hypothermia after hemorrhagic shock (HS) can decrease need of fluid therapy and increase arterial pressure that results in increase the survival rate. But it has not been determined how hypothermia causes these beneficial effects. This study reviews hypothermia effects in this area. This is an experiential study in which 24 rats were divided into four groups. Rats were anesthetized by pentobarbital. In groups 1and3, bilateral renal sympathectomy was done and in the groups 2 and 4 renal nerves remained intact and only lateral incisions were done to preserve similar conditions. Then rats underwent HS phase (phase I) for 90 minutes, by withdrawing 4-6 ml of blood during 10 mines. After shock induction, only in groups 1 and 2, body temperature was lowered to 32oC. At the end of phase I, rats underwent resuscitation phase (phase II) by reinfusion of blood & additional Ringer Lactate to retain normal arterial pressure. Stage II lasted 60 minutes. In hypothermic groups (1 and 2) in comparison to normothermic groups (3 and 4) there was less blood or fluids needed for resuscitation (p<0.05). Arterial pressure before shock was the same in all groups but at the end of phaseII was higher in hypothermic ones (p<0.05). It seems that mild hypothermia has beneficial effects on survival of animals with HS. Although it is obvious that intact kidneys have vital role in maintaining body fluid balance during HS, but it seems hypothermic rats requires lesser fluid therapy even without nerve of kidney. More studies could be probably required to confirm this.

Jaundice is one of the most common problems of neonatal period. It is important because of toxic effect of unconjugate bilirubin on brain and its many severe complications so that invention of a new approach to achieve earlier recovery has always been an issue.

The purpose of this study was to determine the effect of intravenous fluid therapy in addition to phototherapy in reduction of serum bilirubin of affected neonates admitted in hospitals.

The present study was carried out on 60 neonates with indirect hyperbilirubinemia, weighting over 2500 grams, age over 72 hours, total serum bilirubin 17-25 mg/dl, direct bilirubin < 2mg/dl and without systemic and hemolytic diseases (except for glucose-6-phosphotase deficiency) in Imam Sajjad Hospital of Yasuj from May to September 2001. Patients were randomly divided into the study group and control group. In control group, only conventional phototherapy was used and in the study group, intravenous fluidtherapy dextrose water 10%,1.5 times as much as maintenance requirement with NaCl 3 meq/100 cc fluid for a 24 - hour duration, in addition to conventional phototherapy. The patients were discharged when their serum bilirubin reached 12 mg/dl.

Statistically, no significant difference was found between the two groups in terms of age, weight and level of serum bilirubin in admission time. The mean duration of admission in study group was 3.23 days and in control group 4.53 days (P= 0.00005). Also the mean of total serum bilirubin in control and study groups after 24 and 48 hours following treatment were reduced to 16.27 mg/dl and 15. 18 mg/dl (P= 0.039) and 14.29 mg/dl and 12.65 mg/dl (P= 0.0006), respectively.

Maintaining adequate hydration with fluids containing 10% dextrose for infants receiving phototherapy results in faster decline in serum bilirubin level and, therefore, earlier discharge from hospital.