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PubMed1979

[Effect of various plasma substitutes on blood groups].

In order to test the influence of the plasma substitutes Macrodex 6%, Plasmasteril and Expafusin on subsequent blood-typing and serologic tolerance tests, blood specimens of known donors of blood group 0 Rh negative were incubated with the respective plasma substitutes in various dilutions and serologic tests performed. In the AB0 and Rh system, none of the plasma substitutes tested caused falsely positive agglutinations. Reading of cross-match in the albumin test was not impeded in any of the substitutes. The higher molecular dextran Macrodex 6% and the high molecular hydroxyethylene starch Plasmateril appeared to have positive blood-group serologic reactions. With the low molecular hydroxyethylene starch Expafusin no irritations occurred in all tests of cross-matching.

ABO Blood-Group System↗
PubMed1978

[Indications and contraindications for plasma substitutes in surgery].

The indication for the infusion of plasma substitutes has been considerably limited as the result of a series of grave incidents. Prior to each application, differential-therapeutic deliberations must decide on the choice of plasma substitute bringing about the desired success in accordance with its physico-chemical characteristics and clinical values. The type and severity of a probable anaphylactoid incident and its therapy should also be considered.

Anaphylaxis↗
PubMed1991

[Anaphylactoid reaction to Physiogel SRK 4%--a contribution to the controversy about plasma substitutes].

Allergic reactions caused by colloid plasma substitutes are a well known complication in infusion therapy. The incidence of these adverse effects depends on the type of colloid used. Severe anaphylactic or anaphylactoid reactions are generally rare. Nevertheless, the risk of adverse allergic effects is an important aspect of the crystalloid-versus-colloid controversy. The exact pathophysiologic mechanisms remain as yet unclear; reliable prophylactic measures are not universally available. To draw attention to these problems we report a case of severe anaphylactoid reaction to Physiogel SRK.

Anaphylaxis↗
PubMed1980

Molecular aspects of albumin functions: indications for its use in plasma substitution.

The maintenance of the circulating fluid within the vascular system is a major role of plasma albumin. Besides its role as a protein reservoir the third function of albumin is its ability to bind and transport metabolic products, regulatory mediators, nutrients and proteins and to bind and neutralize endogenous or exogenous toxins. Bilirubin binding was chosen as a method to describe functional quality of albumin preparations. Binding at the high affinity site is well preserved in all commercial albumin-containing plasma substitutes investigated with KA values in the range of 3.2 to 4.8 . 10(7) 1/mol. Presence of absence of conventional stabilizers does not influence binding characteristics since heating of products according to various pharmacopoeia levels out any difference. The importance of ligand binding properties of a plasma substitute is stressed either in intoxications, e.g. hyperbilirubinemia of neonates or in surgical situations were multiple drug applications might disturb a balanced binding situation. Though relatively mild in nature and less frequently observed in comparison with artificial plasma substitutes incidence of adverse reactions in connection with albumin was used to search for causes. Biochemical parameters like residual proteolytic activity in general or specified (prekallikrein activator), content of aggregates, anti-complementary activity and influence on granulocyte activity did not give any clear answer in this task, neither did pharmacological testing designed to detect factors leading to histamine and kinin liberation or to detect pyrogens.

Bilirubin↗
PubMed1984

Decrease of plasma fibronectin concentration following infusion of a gelatin-based plasma substitute in man.

Intravenous infusion of 500 ml of a gelatin-based plasma substitute, Haemaccel, given to healthy volunteers, resulted in a significant decrease of the immunoreactive plasma fibronectin concentration 48 h and 72 h after infusion. One hour after infusion, the ability of fibronectin to bind gelatin was inhibited with a gradual recovery within 48 h. A dextran based plasma substitute, Macrodex, did not have this effect on plasma fibronectin.

Adult↗
PubMed1989

The effect of iso-oncotic plasma substitutes: gelatine, dextran 40 (50 g/l) and the effect of Ringer's lactate on the plasma volume in healthy subjects.

82 healthy subjects undergoing Extra-corporeal Shock Wave Lithotripsy (ESWL) under epidural anesthesia were given 1000 ml of either gelatine (Geloplasme), dextran 40, 50 g/l (Isodex) or Ringer's lactate. The purpose of the study was to determine the efficacy of the three described solutions in respect to blood volume changes. A clear differentiation is only possible under absolutely defined physiological conditions and therefore in contrast to other studies, none of these patients was suffering from any shock syndrome or had any blood loss, so no capillary leakage or transcapillary refill problem was present. Plasma volume (PV), colloid oncotic pressure (COP) and hematocrit (Hct) were measured before and 15, 120 and 240 min. after infusion. PV increased both in the gelatine and dextran groups with a higher initial increase in the dextran group. COP increased after 15 min. and Hct decreased after 15 min. in the gelatine and dextran groups. With regard to absolute contraindications this study suggests that dextran 40 can be recommended as plasma substitute due to its higher initial increase in PV, its moderate duration of effect and its low incidence of anaphylactic reaction after a preceding infusion of 20 ml dextran Mw 1000 (Promiten).

Adult↗
PubMed2003

[Clinical study of plasma substitute (Gelofusion) on fluid resuscitation in patients with burned shock].

OBJECTIVE: To investigate the effects of plasma substitute(Gelofusion) on fluid resuscitation in patients with burned shock. METHODS: Twenty burn shock patients with total body surface area (TBSA) more than 40% were enrolled for clinical study on the effect of resuscitation with plasma substitute (Gelofusion). The patients were randomly divided into two groups: Gelofusion resuscitation group (n=11) and plasma resuscitation group (n=9). The cardiac output (CO),oxygen delivery (DO2), packed cell volume (PCV), blood and plasma viscosity, lactate(LA) and base deficit (BD) levels were detected at shock stage (postburn from 1 to 48 hours). RESULTS: Two hours after rapid fluid replacement, the levels of CO and DO2 were gradually increased, while the levels of PCV, blood and plasma viscosity, LA and BD were markedly decreased (P<0.05 or P<0.01). After resuscitation, plasma viscosity in Gelofusion resuscitation group were obviously lower than that in plasma resuscitation group within 24 hours postburn (all P<0.05).With an exception of plasma viscosity, there were no significant differences in other parameters between two groups at various intervals (all P>0.05). CONCLUSION: In the resuscitation of burn shock, the clinical effect of Gelofusion treatment is similar to that of plasma treatment. Gelofusion appears to be a fairly good plasma substitute for extensive application on the management of burn shock during the early stage.

Adolescent↗