LEADER 06791nam 22007934a 450 001 9910961763603321 005 20251017110143.0 010 $a9786610185962 010 $a9780309172790 010 $a0309172799 010 $a9781280185960 010 $a1280185961 010 $a9780309597012 010 $a0309597013 010 $a9780585084947 010 $a0585084947 035 $a(CKB)110986584752682 035 $a(OCoLC)43475659 035 $a(CaPaEBR)ebrary10056969 035 $a(SSID)ssj0000156197 035 $a(PQKBManifestationID)11179188 035 $a(PQKBTitleCode)TC0000156197 035 $a(PQKBWorkID)10123941 035 $a(PQKB)11274932 035 $a(MiAaPQ)EBC3376692 035 $a(Au-PeEL)EBL3376692 035 $a(CaPaEBR)ebr10056969 035 $a(OCoLC)923265590 035 $a(Perlego)4735661 035 $a(DNLM)900545 035 $a(EXLCZ)99110986584752682 100 $a20000318d1999 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 00$aFluid resuscitation $estate of the science for treating combat casualties and civilian injuries /$fAndrew Pope ... [et al.] ; Institute of Medicine 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$dc1999 215 $a1 online resource (207 pages) $cillustrations 300 $aBibliographic Level Mode of Issuance: Monograph 311 0 $a9780309064811 311 0 $a0309064813 320 $aIncludes bibliographical references (p. 125-156) and index. 327 $aFluid Resuscitation -- Copyright -- Reviewers -- Preface -- Photographs -- Contents -- Executive Summary -- 1 Introduction -- HISTORY OF FLUID RESUSCITATION -- ORIGIN, SCOPE AND ORGANIZATION OF THE REPORT -- 2 Pathophysiology of Acute Hemorrhagic Shock -- DEFINITIONS OF HEMORRHAGIC SHOCK -- Organ Involvement in Shock -- PHYSIOLOGIC RESPONSES TO HEMORRHAGE -- Shock Decompensation -- Cellular Responses to Shock -- Altered Energy Metabolism, Ion Compartmentalization, Lipid Metabolism, and Radical Production and Metabolism -- Alterations in Macrophage Function -- Surgical Bleeding Disorders -- Fundamental Alterations in Transcription and Translation: Apoptosis -- Alterations in Secretion of and Cellular Responsiveness to Growth Factors -- HEMATOLOGIC ABNORMALITIES ASSOCIATED WITH SHOCK AND RESUSCITATION -- Transfusion of the Patient in Shock -- Massive Transfusion -- Risks of Blood Transfusion -- Blood Substitutes and Alternatives to Transfusion -- Disseminated Intravascular Coagulation -- CONCLUSIONS AND RECOMMENDATIONS -- 3 Experience With and Complications of Fluid Resuscitation -- OVERVIEW OF COLLOID AND CRYSTALLOID RESUSCITATION -- COMPLICATIONS OF RESUSCITATION IN GENERAL -- Effects of Fluid Resuscitation on Coagulation -- Oxygen Toxicity Associated with Resuscitation -- Reperfusion-Mediated Injury -- Oxygen-Derived Free Radicals -- Nitric Oxide -- Activated Neutrophils -- Complications of Late Resuscitation of Shock -- COMPLICATIONS OF COLLOID RESUSCITATION -- COMPLICATIONS OF CRYSTALLOID RESUSCITATION -- Effects of Crystalloid Resuscitation on Immune Function -- Effects of Crystalloid Resuscitation on Cytokine Response -- Adverse Effects of Large-Volume Crystalloid Resuscitation -- Adverse Effects of Lactated Ringer's Solution -- Safety and Efficacy of Hypertonic Saline Solutions -- ALTERNATIVE RESUSCITATION APPROACHES -- SUMMARY. 327 $aCONCLUSIONS AND RECOMMENDATIONS -- 4 Novel Approaches to Treatment of Shock -- PREVENTION -- Oxygen Therapeutics -- First-, Second-, and Third-Generation Therapeutics -- Perfluorochemicals -- Liposomes -- Other Novel Approaches -- INTERVENTION -- Targets for Intervention -- Therapies for Reperfusion-Mediated Free-Radical Damage -- Antioxidant or Scavenging Strategies -- Iron Chelation -- Inhibition of Polymorphonuclear Neutrophil Adherence and Activation -- Nitric Oxide Inhibition -- Novel Strategies for Scavenging Free Radicals -- Hormonal Influences -- Diagnostic Instrumentation -- TOLERANCE -- RECOMMENDATIONS -- 5 Protocols of Care at the Site of Injury -- THE COMBAT ENVIRONMENT -- Expected Condition of Combatant on the Battlefield -- Limits of Battlefield Care for the Injured Combatant -- Resuscitation Needs of the Injured Combatant on the Battlefield -- Immediate Versus Delayed Fluid Resuscitation -- Current Protocols -- CONCLUSIONS AND RECOMMENDATIONS -- Training First Responders -- Available Approaches for Treatment of Injury -- Hemorrhage -- Airway and Breathing -- Additional Considerations -- Prompt Aeromedical Evacuation -- Monitoring -- 6 Future Directions -- ANIMAL MODELS -- Effects of Extent of Hypotension and Rates of Hemorrhage on Immune Function in Mouse Models -- Swine Models of Combined Hemorrhage and Injury -- Value of Animal Models -- Technical Models -- Role of Anesthesia -- CLINICAL TRIALS -- Role of Clinical Trials in Development of Therapies -- Endpoints and Indications -- Evaluation of Resuscitation Protocols -- Unique Problems of Clinical Trials of Trauma -- Heterogeneity of Subject Population -- Informed Consent -- Applicability of Civilian Clinical Data to Military Needs -- Clinical Research and Clinical Trials in Trauma Centers -- CONCLUSIONS AND RECOMMENDATIONS -- References -- Appendixes -- A Acknowledgments. 327 $aConference Speakers -- Conference Attendees -- Other Contributors -- B Acronyms -- C Conference Agenda -- D Committee and Staff Biographies -- Committee Biographies -- Iom Project Staff -- Index. 330 $aThe challenges associated with immediate resuscitation of the wounded soldier are daunting and often unappreciated by civilian medical personnel. When you consider that field medics frequently work in less than friendly field conditions, exposed to the elements, while carrying only limited medical gear, potentially under fire, you get a sense for the extraordinary obstacles that must be overcome. Which technologies are best suited to this situation? What are the most promising research directions? 606 $aHemorrhagic shock$xTreatment 606 $aFluid therapy 606 $aResuscitation 606 $aMedicine, Military 606 $aFirst aid in illness and injury 615 0$aHemorrhagic shock$xTreatment. 615 0$aFluid therapy. 615 0$aResuscitation. 615 0$aMedicine, Military. 615 0$aFirst aid in illness and injury. 676 $a617.2/1 701 $aPope$b Andrew MacPherson$f1950-$01792828 712 02$aInstitute of Medicine (U.S.) 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910961763603321 996 $aFluid resuscitation$94364158 997 $aUNINA