Issues in Colloid and Transfusion Therapy of Sepsis

Morisaki, H.; Sibbald, William J.

doi:10.1007/978-3-642-84904-6_33

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…This could be related to a reduction in oxygen flux to peripheral cells. HES, by increasing the forces required to dissociate the aggregates, might also reduce oxygen flux from red cells to tissues by impeding its diffusion [18]. On the other hand, Gel increased dramatically whole blood viscosity at corrected PCV, enhancing erythrocyte aggregation and capillary plugging.…”

Section: Discussionmentioning

confidence: 99%

Rheological properties of commonly used plasma substitutes during preoperative normovolaemic acute haemodilution

Freyburger¹,

Dubreuil²,

Boisseau³

et al. 1996

British Journal of Anaesthesia

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Preoperative normovolaemic acute haemodilution (PNAH) is used to reduce major blood loss during elective surgery. Considerable attention has been paid to colloid osmotic pressure, index of diffusibility and intravascular half-life of the currently available substitutes, but there is little information on their rheological properties from in vivo studies. Forty patients undergoing elective aortic reconstruction were given 4% human albumin (HA), 3.5% dextran 40 (Dxt 40), 6% dextran 60 (Dxt 60), 6% hydroxyethylstarch 200 (HES) or modified fluid gelatin (Gel) during PNAH to produce a packed cell volume (PCV) of approximately 30%. Mean volumes of more than 1000 ml were infused. Blood samples were obtained before infusion, immediately after, and 1.5 h after the end of haemodilution. The following variables were measured: PCV, plasma viscosity, whole blood viscosity at measured and corrected PCV (0.45), and erythrocyte aggregation. Haemodynamic and metabolic variables were determined at the same time. The five substitutes had very different effects on red blood cell aggregation and low shear rate viscosity at corrected PCV. Red blood cell aggregation was reduced in the presence of HA, Dxt 40, but was increased moderately to markedly in the presence of the other substitutes in the following order: HES < Dxt 60 < Gel. The influence of the rheological conditions on tissue oxygenation was assessed by measuring the concentration of lactic acid; this was unchanged after PNAH with HA or Dxt 40, but was increased in the presence of HES, Dxt 60 or Gel.

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Section: Discussionmentioning

confidence: 99%

Rheological properties of commonly used plasma substitutes during preoperative normovolaemic acute haemodilution

Freyburger¹,

Dubreuil²,

Boisseau³

et al. 1996

British Journal of Anaesthesia

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“…29 In an animal sepsis model, greater capillary luminal area with less endothelial swelling and less parenchymal injury was found with colloid infusion [HES (pentastarch)] than with RL. 30 In an animal study, goal-directed colloid fluid therapy using HES 130/0.4 significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal-directed crystalloid or restricted crystalloid fluid therapy. 31 In a literature review on the influence of plasma substitutes on microcirculation 27 10 studies using HES in the clinical setting were identified.…”

Section: Microcirculation and Tissue Oxygenationmentioning

confidence: 96%

“…Others also have shown that colloids are able to restore (microcirculatory) perfusion more than crystalloids 29 . In an animal sepsis model, greater capillary luminal area with less endothelial swelling and less parenchymal injury was found with colloid infusion [HES (pentastarch)] than with RL 30 . In an animal study, goal‐directed colloid fluid therapy using HES 130/0.4 significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal‐directed crystalloid or restricted crystalloid fluid therapy 31 …”

Section: Effects Of the Different Volume Replacement Strategiesmentioning

confidence: 99%

Crystalloids versus colloids: the end of an old debate?

Boldt

2010

Transfusion Alternatives in Transfusion Medicine

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SUMMARY The ‘ideal’ plasma substitute for volume replacement remains a matter of dispute. Merits and demerits of colloids versus crystalloids for volume replacement have been discussed very emotionally. Are we any wiser concerning the crystalloid/colloid problem? Recently published meta‐analyses or evidence‐based medicine analyses appear to be less helpful to solve this problem. Conflicting results from different studies are most likely as a result of variations in clinical protocols, selection of patients, criteria for blood or volume administration. With their conflicting results more questions arise than answers are given.

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Oxygen dynamics and induced hypothermia in sepsis

Gilston¹

1994

Resuscitation

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Issues in Colloid and Transfusion Therapy of Sepsis

Cited by 4 publications

References 45 publications

Rheological properties of commonly used plasma substitutes during preoperative normovolaemic acute haemodilution

Rheological properties of commonly used plasma substitutes during preoperative normovolaemic acute haemodilution

Crystalloids versus colloids: the end of an old debate?

Oxygen dynamics and induced hypothermia in sepsis

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