Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,...Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,cluster-randomized,crossover trial,we assigned hospitals in Ontario,Canada,to use either lactated Ringer's solution or normal saline hospital-wide for a period of 12 weeks.展开更多
BACKGROUND Acute pancreatitis(AP)is a frequent gastrointestinal emergency characterized by inflammation.It has the potential to progress to organ failure.Fluid therapy plays a critical role in early AP management,miti...BACKGROUND Acute pancreatitis(AP)is a frequent gastrointestinal emergency characterized by inflammation.It has the potential to progress to organ failure.Fluid therapy plays a critical role in early AP management,mitigating hypovolemia-induced ischemia and systemic inflammatory response syndrome(SIRS).AIM To evaluate dextran 40+Ringer’s lactate solution(RLS)vs RLS alone for fluid therapy in mild to moderate AP.METHODS We conducted a single-center,single-blind,randomized controlled trial involving 108 patients with mild to moderate AP.Participants were randomized to receive either dextran 40+RLS(1:3 ratio)or RLS alone.All patients underwent standardized,goal-directed fluid therapy and were monitored for clinical response,inflammatory markers,and complications.The primary outcomes were reduction in C-reactive protein(CRP)and resolution of SIRS at 72 hours.Secondary outcomes included organ failure,intensive care unit admission,mortality,and length of hospital stay.RESULTS The dextran 40+RLS group demonstrated significantly lower CRP levels.No differences were observed in SIRS changes,fluid overload,refractory status mortality,local complications,or organ failure rates.Hospitalization tended to be shorter in the dextran 40+RLS group(5 days vs 6 days)although not to a statistically significant level(P=0.1).Adverse events were mild and comparable in both groups.CONCLUSION Dextran 40+RLS improved the early CRP response in patients with AP without added complications.Although medium-term outcomes were similar,early benefits support its use in initial management.展开更多
AIM: To investigate whether administration of Ringer's solution(RL) could have an impact on the outcome of acute pancreatitis(AP).METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women,me...AIM: To investigate whether administration of Ringer's solution(RL) could have an impact on the outcome of acute pancreatitis(AP).METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women,mean age 51.2 years(range,19-92 years)] hospitalized between 2011 and 2012. All patients admitted to the Department of Gastroenterology of the Central Clinical Hospital of the Ministry of Interior(Poland) with a diagnosis of AP who had disease onset within 48 h of presentation were included in this study. Based on the presence of persistent organ failure(longer than 48 h) as a criterion for the diagnosis of severe AP(SAP) and the presence of local complications [diagnosis of moderately severe AP(MSAP)],patients were classified into 3 groups: mild AP(MAP),MSAP and SAP. Data were compared between the groups in terms of severity(using the revised Atlanta criteria) and outcome. Patients were stratified into 2 groups based on the type of fluid resuscitation: the 1-RL group who underwent standard fluid resuscitation with a RL 1000 m L solution or the 2-NS group who underwent standard fluid resuscitation with 1000 m L normal saline(NS). All patients from both groups received an additional 5% glucose solution(1000-1500 m L) and a multi-electrolyte solution(500-1000 m L).RESULTS: We observed 64(62.1%) patients with MAP,26(25.24%) patients with MSAP and 13(12.62%) patients with SAP. No significant difference in the distribution of AP severity between the two groups was found. In the 1-RL group,we identified 22(55.5%) MAP,10(25.5%) MSAP and 8(20.0%) SAP patients,compared with 42(66.7%) MAP,16(24.4%) MSAP and 5(7.9%) SAP cases in the 2-NS group(P = 0.187). The volumes of fluid administered during the initial 72-h period of hospitalization were similar among the patients from both the 1-RL and 2-NS groups(mean 3400 m L vs 3000 m L,respectively). No significant differences between the 1-RL and 2-NS groups were found in confirmed pancreatic necrosis [10 patients(25%) vs 12 patients(19%),respectively,P = 0.637]. There were no statistically significant differences between the 1-RL and 2-NS groups in the percentage of patients who required enteral nutrition(23 patients vs 17 patients,respectively,P = 0.534). Logistic regression analysis confirmed these findings(OR = 1.344,95%CI: 0.595-3.035,P = 0.477). There were no significant differences between the 1-RL and 2-NS groups in mortality and the duration of hospital stay(median of 9 d for both groups,P = 0.776).CONCLUSION: Our study failed to find any evidence that the administration of RL in the first days of AP leads to improved clinical outcomes.展开更多
Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v....Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v. infusion of 1000 ml of lactated Ringer＇s solution over 60 min was studied in patients undergoing general （n=31） and epidural （n= 22） anesthesia. Heart rate, arterial blood pressure and hemoglobin （Hb） concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results： General anesthesia caused the greater decrease of mean arterial blood pressure （MAP） （mean 15% versus 9%; P〈0.01） and thereby followed by a more pronounced plasma dilution, blood volume expansion （VE） and blood volume expansion efficiency （VEE）. A strong linear correlation between hemodilution and the reduction in MAP （r=-0.50;P〈0.01） was found. At the end of infusion, patients undergoing general anesthesia retained 47% （SD 19%） of the infused fluid in the circulation, while epidural anesthesia retained 29% （SD 13%） （P〈0.001）. Correspondingly, a fewer urine output （mean 89 ml versus 156 ml; P〈0.05） and extravascular expansion （454 ml versus 551 ml; P〈0.05） were found during general anesthesia. Conclusion： We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.展开更多
The present study aims at understanding the electrochemical impedance and biocorrosion characteristics of AZ91 Mg-alloy in Ringer’s solution.As-cast AZ91 Mg-alloy was subjected to T4 heat treatment in a way to homoge...The present study aims at understanding the electrochemical impedance and biocorrosion characteristics of AZ91 Mg-alloy in Ringer’s solution.As-cast AZ91 Mg-alloy was subjected to T4 heat treatment in a way to homogenize its microstructure by dissolving most of theβ-Mg 17 Al 12 phase at the vicinity of grain boundaries.The electrochemical impedance and biocorrosion performances of these two different microstructures(as-cast and T4 heat treated AZ91 Mg-alloys)in Ringer solution were evaluated by electrochemical impendence spectroscopy,potentiodynamic polarization and weight loss method.EIS spectra showed that both microstructures exhibit similar dynamic response as a function of the immersion time;however,the value of impedance and maximum phase angle are about 50%higher in as-cast AZ91 Mg-alloy as compared to that of homogenized AZ91 Mg-alloy.Weight loss measurement indicated that corrosion resistance of as-cast AZ91 was significantly better than that of homogenized AZ91.Microstructural and XRD analysis revealed that as-cast AZ91 contains a passive film of MgCO_(3)and CaCO_(3)precipitates with near spherical morphologies,whereas homogenized AZ91 comprised mainly unstable Mg(OH)_(2)film featured by irregular plate-like morphologies.展开更多
A plasma electrolytic nitrocarburising （PEN/C） process was performed on stainless steel 316L to improve the surface properties for using as medical implants. A bath was optimised to reduce the required voltage to 15...A plasma electrolytic nitrocarburising （PEN/C） process was performed on stainless steel 316L to improve the surface properties for using as medical implants. A bath was optimised to reduce the required voltage to 150 volts. Aqueous urea-based solutions with 10% NH4Cl were prepared with slightly different amounts of Na2CO3 to optimise the electrolyte composition. The surface and the cross-section morphologies were studied by scanning electron microscopy. The microstructure and the chemical composition of samples were investigated by X-ray diffraction （XRD） and energy dispersive X-ray （EDX） techniques. The microstructure of the outer layer of the coatings was found to be a complex oxide containing Cr and Fe. The wear properties of the samples were examined by using a pin on disk wear test with Ringer＇s solution and were compared with their wear properties in the ambient atmosphere. The Ringe（s solution acted as a lubricant, reducing friction coefficient. Hardness and roughness were also studied. The bath with the composition of 10% NH4CI and 3% Na2CO3 exhibited the best tribological properties. The results showed that the tribological properties of treated samples were improved and the wear mechanism was abrasion of the pin.展开更多
The electrochemical behaviors of commercially pure titanium (CP Ti) and Co-Cralloy in Ringer's solution have been investigated. The results indicate that the electric potentialof passive region for CP Ti is up to ...The electrochemical behaviors of commercially pure titanium (CP Ti) and Co-Cralloy in Ringer's solution have been investigated. The results indicate that the electric potentialof passive region for CP Ti is up to 3000 mV, and its passive current density is 3.078 μA/cm^2.The excellent corrosion resistance of CP Ti can be attributed to the formation of TiO_2 oxide film.The passive region of Co-Cr alloy is 770 mV, which is narrower than that of CP Ti. However, nohysteresis loops are found in the reverse scanning curves of Cu-Cr alloy. A complex oxide film ofCo_3O_4, Co_2O_3, and Cr_2O_3 formed on the surface provides Co-Cr alloy with a stableelectrochemistry property. The corrosion rates of the crevice samples increase with the pH value ofmedium decreasing. The electron probe microanalyzer (EPMA) analysis indicates that Ti in CP Ti andCo, Cr in Co-Cr alloy dissolve in crevice area due to the Sealed-Cell effect.展开更多
BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of...BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of hydroxyapatite,which is highly infilt-rative to tissues,thus making complete resection difficult.An adjuvant method to remove or resolve the residual crystals during the operation is necessary.CASE SUMMARY A bicarbonate Ringer’s solution with bicarbonate ions(28 mEq/L)was used as the adjuvant.After resecting calcium phosphate deposits of tumoral calcinosis as much as possible,while filling with the solution,residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field.A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders,bilateral hip joints,and the right foot.A shoulder lesion was resected,but the calcification remained and early re-deposition was observed.Considering the difficulty of a complete rection,we devised a bicarbonate dissolution method and excised the foot lesion.After resection of the calcified material,the residual calcified material was washed away with bicarbonate Ringer’s solution.CONCLUSION The bicarbonate dissolution method is a new,simple,and effective treatment for tumoral calcinosis in hemodialysis patients.展开更多
Objective: Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins. Design: A retrospective cohort study. Se...Objective: Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins. Design: A retrospective cohort study. Setting: The National Burns Unit, Mafraq Hospital, Abu Dhabi, United Arab Emirates (UAE). Patients: One hundred and fifteen patients admitted with fresh burns between 1st of January 2011 and 31st of December 2013, who met inclusion and exclusion criteria. Methods: Team collected demographic and clinical data for each patient using a standard form. Patients received Ringer Lactate solely as the resuscitative burn fluid according to Parkland Formula. Baseline (pre-) and third-day (post-) variables included levels of sodium, potassium, chloride, proteins, and albumin. Researchers then performed paired comparisons of serum electrolytes and protein levels. Results: Mean values showed maintenance of the potassium and chloride levels within the normal range after administering the Ringer Lactate, significant decline in sodium, and a marked hypoproteinaemia and hypoalbuminaemia post-resuscitation. Conclusions: Ringer Lactate used as the mere resuscitative post burn fluid is suboptimal. Sodium supplementation may be required to correct hyponatremia. Colloids, preferably intravenous albumin should be added, as advised by the original Parkland Formula.展开更多
Objective To investigate the feasibility and clinical effects of the pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy.Methods From January 2005 to July 2009,23 patientswere...Objective To investigate the feasibility and clinical effects of the pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy.Methods From January 2005 to July 2009,23 patientswere treated with the展开更多
文摘Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,cluster-randomized,crossover trial,we assigned hospitals in Ontario,Canada,to use either lactated Ringer's solution or normal saline hospital-wide for a period of 12 weeks.
文摘BACKGROUND Acute pancreatitis(AP)is a frequent gastrointestinal emergency characterized by inflammation.It has the potential to progress to organ failure.Fluid therapy plays a critical role in early AP management,mitigating hypovolemia-induced ischemia and systemic inflammatory response syndrome(SIRS).AIM To evaluate dextran 40+Ringer’s lactate solution(RLS)vs RLS alone for fluid therapy in mild to moderate AP.METHODS We conducted a single-center,single-blind,randomized controlled trial involving 108 patients with mild to moderate AP.Participants were randomized to receive either dextran 40+RLS(1:3 ratio)or RLS alone.All patients underwent standardized,goal-directed fluid therapy and were monitored for clinical response,inflammatory markers,and complications.The primary outcomes were reduction in C-reactive protein(CRP)and resolution of SIRS at 72 hours.Secondary outcomes included organ failure,intensive care unit admission,mortality,and length of hospital stay.RESULTS The dextran 40+RLS group demonstrated significantly lower CRP levels.No differences were observed in SIRS changes,fluid overload,refractory status mortality,local complications,or organ failure rates.Hospitalization tended to be shorter in the dextran 40+RLS group(5 days vs 6 days)although not to a statistically significant level(P=0.1).Adverse events were mild and comparable in both groups.CONCLUSION Dextran 40+RLS improved the early CRP response in patients with AP without added complications.Although medium-term outcomes were similar,early benefits support its use in initial management.
文摘AIM: To investigate whether administration of Ringer's solution(RL) could have an impact on the outcome of acute pancreatitis(AP).METHODS: We conducted a retrospective study on 103 patients [68 men and 35 women,mean age 51.2 years(range,19-92 years)] hospitalized between 2011 and 2012. All patients admitted to the Department of Gastroenterology of the Central Clinical Hospital of the Ministry of Interior(Poland) with a diagnosis of AP who had disease onset within 48 h of presentation were included in this study. Based on the presence of persistent organ failure(longer than 48 h) as a criterion for the diagnosis of severe AP(SAP) and the presence of local complications [diagnosis of moderately severe AP(MSAP)],patients were classified into 3 groups: mild AP(MAP),MSAP and SAP. Data were compared between the groups in terms of severity(using the revised Atlanta criteria) and outcome. Patients were stratified into 2 groups based on the type of fluid resuscitation: the 1-RL group who underwent standard fluid resuscitation with a RL 1000 m L solution or the 2-NS group who underwent standard fluid resuscitation with 1000 m L normal saline(NS). All patients from both groups received an additional 5% glucose solution(1000-1500 m L) and a multi-electrolyte solution(500-1000 m L).RESULTS: We observed 64(62.1%) patients with MAP,26(25.24%) patients with MSAP and 13(12.62%) patients with SAP. No significant difference in the distribution of AP severity between the two groups was found. In the 1-RL group,we identified 22(55.5%) MAP,10(25.5%) MSAP and 8(20.0%) SAP patients,compared with 42(66.7%) MAP,16(24.4%) MSAP and 5(7.9%) SAP cases in the 2-NS group(P = 0.187). The volumes of fluid administered during the initial 72-h period of hospitalization were similar among the patients from both the 1-RL and 2-NS groups(mean 3400 m L vs 3000 m L,respectively). No significant differences between the 1-RL and 2-NS groups were found in confirmed pancreatic necrosis [10 patients(25%) vs 12 patients(19%),respectively,P = 0.637]. There were no statistically significant differences between the 1-RL and 2-NS groups in the percentage of patients who required enteral nutrition(23 patients vs 17 patients,respectively,P = 0.534). Logistic regression analysis confirmed these findings(OR = 1.344,95%CI: 0.595-3.035,P = 0.477). There were no significant differences between the 1-RL and 2-NS groups in mortality and the duration of hospital stay(median of 9 d for both groups,P = 0.776).CONCLUSION: Our study failed to find any evidence that the administration of RL in the first days of AP leads to improved clinical outcomes.
基金Project (No. 20051899) supported by Office of Education of Zheji-ang Province, China
文摘Objective： To investigate the dynamics of vascular volume and the plasma dilution of lactated Ringer＇s solution in patients during the induction of general and epidural anesthesia. Methods： The hemodilution of i.v. infusion of 1000 ml of lactated Ringer＇s solution over 60 min was studied in patients undergoing general （n=31） and epidural （n= 22） anesthesia. Heart rate, arterial blood pressure and hemoglobin （Hb） concentration were measured every 5 rain during the study. Surgery was not started until the study period had been completed. Results： General anesthesia caused the greater decrease of mean arterial blood pressure （MAP） （mean 15% versus 9%; P〈0.01） and thereby followed by a more pronounced plasma dilution, blood volume expansion （VE） and blood volume expansion efficiency （VEE）. A strong linear correlation between hemodilution and the reduction in MAP （r=-0.50;P〈0.01） was found. At the end of infusion, patients undergoing general anesthesia retained 47% （SD 19%） of the infused fluid in the circulation, while epidural anesthesia retained 29% （SD 13%） （P〈0.001）. Correspondingly, a fewer urine output （mean 89 ml versus 156 ml; P〈0.05） and extravascular expansion （454 ml versus 551 ml; P〈0.05） were found during general anesthesia. Conclusion： We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.
文摘The present study aims at understanding the electrochemical impedance and biocorrosion characteristics of AZ91 Mg-alloy in Ringer’s solution.As-cast AZ91 Mg-alloy was subjected to T4 heat treatment in a way to homogenize its microstructure by dissolving most of theβ-Mg 17 Al 12 phase at the vicinity of grain boundaries.The electrochemical impedance and biocorrosion performances of these two different microstructures(as-cast and T4 heat treated AZ91 Mg-alloys)in Ringer solution were evaluated by electrochemical impendence spectroscopy,potentiodynamic polarization and weight loss method.EIS spectra showed that both microstructures exhibit similar dynamic response as a function of the immersion time;however,the value of impedance and maximum phase angle are about 50%higher in as-cast AZ91 Mg-alloy as compared to that of homogenized AZ91 Mg-alloy.Weight loss measurement indicated that corrosion resistance of as-cast AZ91 was significantly better than that of homogenized AZ91.Microstructural and XRD analysis revealed that as-cast AZ91 contains a passive film of MgCO_(3)and CaCO_(3)precipitates with near spherical morphologies,whereas homogenized AZ91 comprised mainly unstable Mg(OH)_(2)film featured by irregular plate-like morphologies.
基金supported by the Research Committee of Shiraz University under grant No.88-GR-ENG-62,which is gratefully appreciated
文摘A plasma electrolytic nitrocarburising （PEN/C） process was performed on stainless steel 316L to improve the surface properties for using as medical implants. A bath was optimised to reduce the required voltage to 150 volts. Aqueous urea-based solutions with 10% NH4Cl were prepared with slightly different amounts of Na2CO3 to optimise the electrolyte composition. The surface and the cross-section morphologies were studied by scanning electron microscopy. The microstructure and the chemical composition of samples were investigated by X-ray diffraction （XRD） and energy dispersive X-ray （EDX） techniques. The microstructure of the outer layer of the coatings was found to be a complex oxide containing Cr and Fe. The wear properties of the samples were examined by using a pin on disk wear test with Ringer＇s solution and were compared with their wear properties in the ambient atmosphere. The Ringe（s solution acted as a lubricant, reducing friction coefficient. Hardness and roughness were also studied. The bath with the composition of 10% NH4CI and 3% Na2CO3 exhibited the best tribological properties. The results showed that the tribological properties of treated samples were improved and the wear mechanism was abrasion of the pin.
基金This project is financially supported by the Natural Science Foundation of Liaoning Province (No.972210), China
文摘The electrochemical behaviors of commercially pure titanium (CP Ti) and Co-Cralloy in Ringer's solution have been investigated. The results indicate that the electric potentialof passive region for CP Ti is up to 3000 mV, and its passive current density is 3.078 μA/cm^2.The excellent corrosion resistance of CP Ti can be attributed to the formation of TiO_2 oxide film.The passive region of Co-Cr alloy is 770 mV, which is narrower than that of CP Ti. However, nohysteresis loops are found in the reverse scanning curves of Cu-Cr alloy. A complex oxide film ofCo_3O_4, Co_2O_3, and Cr_2O_3 formed on the surface provides Co-Cr alloy with a stableelectrochemistry property. The corrosion rates of the crevice samples increase with the pH value ofmedium decreasing. The electron probe microanalyzer (EPMA) analysis indicates that Ti in CP Ti andCo, Cr in Co-Cr alloy dissolve in crevice area due to the Sealed-Cell effect.
文摘BACKGROUND Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues,occurring in hemodialysis patients.Calcium phosphate crystals are mainly composed of hydroxyapatite,which is highly infilt-rative to tissues,thus making complete resection difficult.An adjuvant method to remove or resolve the residual crystals during the operation is necessary.CASE SUMMARY A bicarbonate Ringer’s solution with bicarbonate ions(28 mEq/L)was used as the adjuvant.After resecting calcium phosphate deposits of tumoral calcinosis as much as possible,while filling with the solution,residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field.A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders,bilateral hip joints,and the right foot.A shoulder lesion was resected,but the calcification remained and early re-deposition was observed.Considering the difficulty of a complete rection,we devised a bicarbonate dissolution method and excised the foot lesion.After resection of the calcified material,the residual calcified material was washed away with bicarbonate Ringer’s solution.CONCLUSION The bicarbonate dissolution method is a new,simple,and effective treatment for tumoral calcinosis in hemodialysis patients.
文摘Objective: Evaluation of the effect of Ringer Lactate, as the resuscitative burn fluid according to Parkland Formula, on restoring the levels of body electrolytes and proteins. Design: A retrospective cohort study. Setting: The National Burns Unit, Mafraq Hospital, Abu Dhabi, United Arab Emirates (UAE). Patients: One hundred and fifteen patients admitted with fresh burns between 1st of January 2011 and 31st of December 2013, who met inclusion and exclusion criteria. Methods: Team collected demographic and clinical data for each patient using a standard form. Patients received Ringer Lactate solely as the resuscitative burn fluid according to Parkland Formula. Baseline (pre-) and third-day (post-) variables included levels of sodium, potassium, chloride, proteins, and albumin. Researchers then performed paired comparisons of serum electrolytes and protein levels. Results: Mean values showed maintenance of the potassium and chloride levels within the normal range after administering the Ringer Lactate, significant decline in sodium, and a marked hypoproteinaemia and hypoalbuminaemia post-resuscitation. Conclusions: Ringer Lactate used as the mere resuscitative post burn fluid is suboptimal. Sodium supplementation may be required to correct hyponatremia. Colloids, preferably intravenous albumin should be added, as advised by the original Parkland Formula.
文摘Objective To investigate the feasibility and clinical effects of the pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy.Methods From January 2005 to July 2009,23 patientswere treated with the
