Darrow's infusion 500ml bags

Background: Ex vivo lung perfusion (EVLP) supports assessment and rehabilitation of donor lungs. It runs as a closed circuit, so electrolytes and metabolites accumulate over the duration of perfusion. This systematic review investigates the impact of various dialysis or perfusate exchange (PE) techniques on electrolyte balance, inflammation and lung function during EVLP. Methods: A literature search of PubMed and Embase was conducted from database inception to September 17, 2025. We included all articles describing human or animal studies that tested dialysis or PE during EVLP. Outcomes included electrolytes, lactate, pH, edema formation, lung performance characteristics, and inflammatory markers. Results: Five studies met the inclusion criteria, one human and four porcine models, with a total of 57 subjects. Across studies, dialysis consistently improved solute clearance, lowering sodium, potassium, and chloride, while increasing calcium and glucose, reducing lactate accumulation, and maintaining physiologic pH. PE did not sustain physiologic pH and had limited impact on electrolyte homeostasis, with only transient effects on lactate. No differences were observed in lung function parameters including oxygenation, compliance, and airway pressure. Pro-inflammatory cytokine production was largely unchanged, however, interleukin (IL)-10 was elevated with dialysis in several studies. Conclusion: During EVLP, dialysis stabilized acid-base status and metabolites. These biochemical gains did not translate into consistent improvements in oxygenation or compliance. Smaller dialysis membranes were associated with higher pulmonary artery pressure (PAP) and increased cytokine profile. Future studies should extend EVLP duration with perfusate clearance to evaluate whether perfusate clearance strategies provide additional benefits with longer duration preservation.

Abstract licence: CC BY-NC-ND

Sodium lactate–based solutions have been proposed as an alternative to conventional osmotic therapies for intracranial pressure (ICP) control in acute brain injury (ABI). Beyond their osmotic properties, lactate may also act as a cerebral metabolic substrate, although its effects appear context-dependent. The aim of this systematic review was to synthesize available data on lactate-based therapies in ABI, focusing on their effects on intracranial dynamics, cerebral metabolism and neurological outcomes to guide future clinical translation. We performed a systematic review of preclinical and clinical studies evaluating exogenous sodium lactate administration in ABI, including traumatic brain injury, ischemic stroke, and cardiac arrest. Outcomes of interest included intracranial pressure control, cerebral metabolism, cerebral perfusion and oxygenation, systemic hemodynamics, safety, and functional recovery. Twelve preclinical and twelve clinical studies were included. Across most models, sodium lactate was effective in reducing ICP and at least as effective and safe as mannitol or hypertonic saline in clinical settings. Several studies reported improved systemic hemodynamic tolerance compared with conventional osmotherapy. Preclinical and clinical metabolic data demonstrated that lactate can be taken up and oxidized by the injured brain; however, metabolic benefits were inconsistent and appeared dependent on preserved oxidative metabolism, baseline metabolic status, timing, and dose. Functional outcome data were limited but suggested potential cognitive and neurological benefits in both experimental and selected clinical settings. Sodium lactate is an effective therapy for intracranial hypertension and may offer additional metabolic and systemic advantages in ABI patients under specific conditions. Its metabolic effects appear critically dependent on preserved oxidative capacity, highlighting the need for improved patient selection and the potential role of metabolic monitoring to guide therapy. The impact of lactate-based treatments on meaningful functional outcomes remains uncertain and warrants further investigation in targeted clinical trials.

Abstract licence: CC BY-NC-ND

The search for alternative salt formulations similar to sodium chloride and their effect on marinated meat products is of great significance to the low-sodium meat processing industry. The main purpose of this study was to investigate the effect of partially replacing sodium chloride with potassium lactate, calcium ascorbate, and magnesium chloride on the sodium content, water activity and distribution, protein solubility, microstructure, sensory characteristics and volatile flavor compounds in low-sodium marinated beef. The sodium content in the test group decreased up to 28% compared to 100% in the sodium chloride group C1. The formulation including 60% sodium chloride and a total of 40% compound alternative salts in groups F1 and F2 increased their myofibril fragmentation index and promoted the disruption of the myogenic fiber structure. Group F1 (the ratio of potassium lactate, calcium ascorbate and magnesium chloride was 2:1:1) performed higher solubility of myofibrillar proteins and lower transverse relaxation value than group F2 detected by low-field nuclear magnetic resonance, which indicated that F1 formulation was beneficial to promote the solubility of myofibrillar proteins and attenuate the water mobility of marinated beef. Moreover, group F1 had a more similar microstructure and more similar overall sensory attributes to group C1 according to the scanning electron microscopy. The sensory evaluation showed higher peak intensity and response values of volatile flavor compounds than group C1 and C2 (only 60% sodium chloride) when detected using gas chromatography-ion mobility spectrometry technology, which indicated that the compound alternative salts of group F1 can improve the lower quality of low-sodium marinated beef and perform similar attributes to the C1 sample regarding moisture distribution and microstructure and even performs better than it with regards to flavor. Therefore, the F1 formula possessed greater potential for application in low-sodium marinated meat products.

Abstract licence: CC BY

Sodium chloride (NaCl) is a commonly used additive in minimally processed fish-based products. The addition of NaCl to fish products and packaging in a modified atmosphere is usually efficient with regard to limiting the occurrence of the aquatic environmental pathogen Pseudomonas aeruginosa. Given the negative effects of excess NaCl in the diet, there is a growing demand to reduce NaCl in food products with safer substituents, but the knowledge of their impact on antibiotic resistant P. aeruginosa is limited. This study aimed to evaluate the physiological and transcriptome characteristics of P. aeruginosa NT06 isolated from fish and to determine the effect of selected concentrations of alternative NaCl compounds (KCl/NaL/NaC) on the P. aeruginosa NT06 virulence phenotype and genotype. In the study, among the isolated microorganisms, P. aeruginosa NT06 showed the highest antibiotic resistance (to ampicillin, ceftriaxone, nalidixic acid, and norfloxacin) and the ability to grow at 4 °C. The Comprehensive Antibiotic Resistance Database (CARD) and the Virulence Factor Database (VFDB) revealed the presence of 24 and 134 gene products assigned to AMR and VF in the P. aeruginosa NT06 transcriptome, respectively. KCl, KCl/NaL and KCl/NaL/NaC inhibited pyocyanin biosynthesis, elastase activity, and protease activity from 40 to 77%. The above virulence phenotypic observations were confirmed via RT–qPCR analyses, which showed that all tested AMR and VF genes were the most downregulated due to KCl/NaL/NaC treatment. In conclusion, this study provides insight into the potential AMR and VF among foodborne P. aeruginosa and the possible impairment of those features by KCl, NaL, and NaC, which exert synergistic effects and can be used in minimally processed fish-based products.

Abstract licence: CC BY

Pseudomonas aeruginosa is an opportunistic pathogen that recently has been increasingly isolated from foods, especially from minimally processed fish-based products. Those are preserved by the addition of sodium chloride (NaCl) and packaging in a modified atmosphere. However, the current trends of minimizing NaCl content may result in an increased occurrence of P. aeruginosa. NaCl can be replaced with potassium chloride (KCl) or sodium salts of organic acids. Herein, we examined the antimicrobial effects of KCl, sodium lactate (NaL), sodium citrate (NaC), and sodium acetate (NaA) against P. aeruginosa NT06 isolated from fish. Transcriptome response of cells grown in medium imitating a fish product supplemented with KCl and KCl/NaL/NaC and maintained under microaerophilic conditions was analysed. Flow cytometry analysis showed that treatment with KCl and KCl/NaL/NaC resulted in changed metabolic activity of cells. In response to KCl and KCl/NaL/NaC treatment, genes related to cell maintenance, stress response, quorum sensing, virulence, efflux pump, and metabolism were differentially expressed. Collectively, our results provide an improved understanding of the response of P. aeruginosa to NaCl alternative compounds that can be implemented in fish-based products and encourage further exploration of the development of effective methods to protect foods against the P. aeruginosa, underestimate foodborne bacteria.

Abstract licence: CC BY

Human serum albumin (HSA) solution is widely used as a replacement fluid during therapeutic plasma exchange (TPE). However, the ionic concentrations in commercially available 5% HSA solutions differ significantly from physiological levels. In this study, we developed a simple method for preparing a replacement fluid with ion concentrations closer to physiological norms by mixing 25% HSA with lactated Ringer's solution, sodium chloride, and calcium gluconate hydrate. We prepared three types of replacement fluids, each with a 4.0% albumin concentration and total volumes of 1.83, 2.43, and 3.04 L, and confirmed their compositional stability for up to 48 h. Compared with the standard 5% HSA solution, the prepared fluids had calcium, sodium, potassium, and chloride levels more closely aligned with physiological values. Using HSA-based replacement fluids with preadjusted electrolyte concentrations may help reduce the risk of imbalances, such as hypocalcemia, during TPE.

Abstract licence: CC BY