Group items tagged

LR’s acid base balance is superior to that of NS’s

There were no significant differences between LR and NS groups in fibrinogen concentrations or platelet count

Total protein dropped

no significant differences in Hct (Table  1) or total protein between LR and NS groups

Bicarbonate HCO3- levels were decreased by hemorrhage but returned to pre-hemorrhage values by 3 h after LR resuscitation, whereas no return was observed with NS resuscitation

Na+ was increased after NS resuscitation

No changes in Na+ or K+ were observed

K+ did not change initially after NS resuscitation but was elevated at 6 h afterwards

Ca++ was similarly decreased

Cl- was elevated for 6 h after NS resuscitation, with no changes shown after LR resuscitation

PT was similarly prolonged by resuscitation with LR (from 11.2 ± 0.2 sec at baseline to 12.1 ± 0.2 sec at 6 h) and NS

Plasma aPTT was also similarly prolonged by resuscitation with LR (from 17.1 ± 0.5 sec baseline to 20.1 ± 1.2 sec at 6 h) or NS

NS resuscitation resulted in better oxygen delivery and oxygen delivery-to-oxygen demand ratio as an index of oxygen debt

NS had better tissue perfusion and oxygen metabolism than LR

LR resuscitation returned BE and bicarbonate to pre-hemorrhage levels within 3 h, but no return of BE or bicarbonate was observed for 6 hr with NS resuscitation

current blood bank guidelines state that LR should not be mixed with blood to prevent the risk of clot formation from calcium included in LR

LR resuscitation should not be given with blood through the same iv-line and crystalloids should be avoided in patients with blood transfusion

PT and aPTT were prolonged for 6 h after hemorrhage and resuscitation, suggesting a hypocoagulable states

potential thrombotic risk from LR resuscitation is unlikely.

we suspected that the blood pressure after NS resuscitation would be lower than that of LR due to its vasodilator effects

NS required a larger resuscitation volume and was associated with poor acid base status and elevated serum potassium in this model

NS required 50% more volume and was associated with a higher cardiac output and lower peripheral resistance, as compared to LR resuscitation

These differences are possibly due to the vasodilator effects from NS

an elevation of K+ was observed at 6 h post NS resuscitation, while no change of K+ was observed after LR resuscitation

The mechanism for the increase of K+ from NS is not fully known

NS is associated with vasodilator effects and the risks of metabolic acidosis and hyperkalemia

The rate of water loss can be quantified through measurement of sweat rate

Pre- and postexercise body weight measurements are the most common means to estimate overall water loss but are condition specific

It appears that 1% to 2% body weight loss is well tolerated by the exercising athlete

Dehydration, defined as greater than 2% loss of body weight, can negatively affect performance

In highly trained endurance athletes, plasma volume and sodium serum concentration were preserved despite a 5% body weight loss

In Ironman triathletes, dehydration to 5% body weight loss did not correlate with occurrence of medical complications

hydration should begin hours prior to exercise, especially if known deficits are present, and fluids should be consumed at a slow, steady rate, with 5 to 7 mL/kg taken 4 hours prior to exercise

Sodium concentration did not produce significant changes in the rate of absorption but was primarily dependent on carbohydrate concentration

Replacing 150% of body weight loss over 60 minutes has been tolerated without complications

IV treatment of severe dehydration (>7% body weight loss), exertional heat illness, nausea, emesis, or diarrhea, and in those who cannot ingest oral fluids for other reasons, is clinically indicated

A recent survey of the National Football League teams revealed that 75% (24 of 32) of the teams utilized IV infusion of fluids for prehydration in at least some otherwise healthy individuals

In the National Football League, an average of 1.5 L of normal saline was administered approximately 2.5 hours prior to competition

after 2 hours of exercise, the rectal temperature was 0.6° higher in the group not receiving IV infusion. Also, stroke volume and cardiac output were 11% to 16% lower in the control group versus the IV infusion group.

Recent evidence suggests the etiology of EAMC is related to muscle fatigue and neuronal excitability

no correlation between hydration status or electrolyte concentrations with EAMC

there may be a subset of muscle cramping that is associated with a loss of both body fluid and sodium

Glycerol is the primary agent for oral hyperhydration

elevation of plasma volume by 200 to 300 mL via dextran infusion resulted in 15% increase in stroke volume, 4% increase in VO2 max, and an increase in the exercise time to fatigue

Neither the tonicity nor mode of hydration resulted in improved speed of rehydration, greater fluid retention, or improved performance

There are beneficial anecdotal reports of EAMC treatment in elite and professional-level athletes with IV hydration during the course of an event

Plasma volume was better restored during rehydration with IV fluids at preexercise and 5 minutes of exercise. At 15 minutes, there was no difference between IV and oral rehydration

More rapid restoration of plasma volume was accomplished in the IV treatment group with no advantages over oral rehydration in physiological strain, heat tolerance, ratings of perceived effort, or thermal sensations

No difference was found in exercise time to exhaustion. IV and oral rehydration methods were equally effective. Heart rates were statistically higher in the oral rehydration group through 75 minutes of exercise, and there were higher increases in norepinephrine plasma concentrations

No significant differences between the groups were found for time to recovery, number of days with pain, number of days with stiffness, sleep disturbance, fatigue, rectal temperature, and loss of appetite

The current data suggest that IV rehydration is faster than oral

There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route

Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase

The use of IV fluid may be beneficial for a subset of fluid sensitive athletes

this should be reserved for high-level athletes with strong histories of symptoms in well-monitored settings.

Volume expanders may also be beneficial for some athletes