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PubMed1975

Rational use of albumin and plasma substitutes.

Salt-poor human albumin (25 g/dl) is a safe and effective colloid for increasing intravascular volume. It is usually given together with saline solutions at a final concentration of 5 g albumin per 100 ml infusion volume. Although relatively nontoxic, albumin costs about $120 per liter, more than ten times the cost of artificial macromolecular colloids used as "plasma substitutes". Hydroxyethyl starch (6 g/dl NaCl) is a new polysaccharide volemic colloid similar in effect to dextran-70; 70% of an infused volume remains intravascular at 3 hours and 30% at 24 hours. It is nonallergenic, causes no anaphylactoid reactions, and interferes with coagulation less than dextran-70 or dextran-40. Bleeding may be observed when doses of more than 1500 ml are given without blood replacement, especially in thrombocytopenic patients. The effects of dextran-70 and dextran-40 on inhibiting thrombogenesis and facilitating blood flow in small vessels are due largely to hemodilution; the relative efficacy of hydroxyethyl starch for these purposes has not yet been established. Hydroxyethyl starch is a safe and effective colloidal solution for replacement of lost blood and augmentation of blood volume.

Blood Viscosity↗
PubMed1976

[The influence of different plasma substitutes on blood clotting and platelet function during and after operations (author's transl)].

It has been shown in clinical experiments that plasma substitutes generally have a specific-colloidal influence on special parts of the clotting system. These changes are predominant after infusion of dextran, since on one hand there is an inhibition of platelet function, and on the other hand a decrease in the activity of plasmatic clotting factors. It is to be emphasized that hydroxyethyl starch and with some restrictions even gelatins cause a comparable inhibition of platelet function. These reactions are due to colloid-specific effects only, which have been unknown up to now. Activities of plasmatic clotting factors, however, are not influenced by these substitutes.

Blood Coagulation↗
PubMed1978

[Comparative study on the immunogenicity of plasma substitutes with gelatin base in animal experiments].

The immune response of rabbits and guinea pigs to gelatin and to three commercial plasma substitutes based on gelatin (oxypolygelatin [OPG], di-isocyanate cross-linked gelatin [DCG], modified fluid gelatin [MFG]) has been reevaluated. Passive hemagglutination, passive cutaneous anaphylaxis and active anaphylaxis have been used to detect the response of animals immunized in complete Fruend's adjuvant or in aluminium hydroxide. Marked immune responses were observed with DCG and MFG which were to a large extent specific for the immunizing antigen (i.e. the corresponding chemically modified gelatin). Gelatin and OPG induced weak responses. In contrast to DCG and MFG in systemic anaphylactic shock experiments no anaphylactic shock could be elicited with gelatin and OPG. A limited series of immunizations in guinea pigs of various strains demonstrated that responses to weak immunogens, such as modified gelatins, are markedly influenced by genetic factors.

Amino Acids↗