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At least 127 records · Page 7Linked to original sources
PubMed1980

Skeletal muscle microcirculation and oxygenation in experimental intestinal shock: A study on the efficacy of different plasma substitutes.

Shock was induced in 60 dogs by exteriorization of the small intestine for three hours. The relative effectiveness of various hemodiluting agents on the microcirculation was measured as skeletal muscle capillary blood flow (QXe) and capillary permeability (P) surface area (S) for plasma (PSp), as calculated from the clearances of two locally injected isotopes, 133 Xenon and 131 Iodide. Skeletal muscle oxygen tension (Pm(2) was measured with a tissue PO2 electrode. During shock QZe decreased to 26%, PSp to 31% of the initial values, and PmO2 dropped from 51 to 18 mmHg. The degree of recovery from shock was assessed after reposition of the intestine and the infusion of different plasma substitutes (albumin, dextran 40, dextran 70, gelatin, ACD-plasma, and Ringer's acetate). Return of the intestine to the abdominal cavity did not in itself improve the shock condition. Dextran 40 and dextran 70 infusion increased QXe, PSp, and PmO2 to or above control levels, PSp to 60%, and QXe to 40% of the control values. Ringer's acetate gelatin, and ACD-plasma did not improve QXe but increased PSq to 62-67% of control values. Albumin and dextran increased PmO2 significantly in relation to no-fluid infusion. Only dextran 40 and dextran 70 increased both QXe and PSp significantly in relation to no -fluid infusion.

Anesthesia↗
PubMed1981

Effects of the gelatin plasma substitutes Haemaccel, Plasmagel and Plasmion (Geloplasma) on collagen-, ADP- and adrenaline-induced aggregation of human platelets in vitro.

The effect of some gelatin plasma substitutes (Haemaccel, plasmagel and Plasmion (Geloplasma), which are widely used in Europe) on collagen-, ADP- and adrenaline-induced platelet aggregation in human PRP in vitro was studied under controlled conditions (pH, electrolyte composition). Haemaccel inhibited these aggregations, both in citrated as well as in heparinised PRP, whereas they were enhanced by both Plasmagel and Plasmion as compared to the appropriate control. Increasing teh concentration of the inducer overcame the inhibition by Haemaccel. Haemaccel inhibited, while Plasmion enhanced 14C-serotonin release induced by collagen, ADP or adrenaline. Also in the presence of indomethacin (90 muM) Haemaccel inhibited aggregation induced by high concentrations of collagen and the primary aggregation induced by ADP and adrenaline, while Plasmion enhanced these aggregations induced by ADP and adrenaline, while Plasmion enhanced these aggregations. The inhibition by Haemaccel was not caused by binding of Ca2+ to haemaccel.

Adenosine Diphosphate↗
PubMed1992

[In vivo rheologic studies of plasma substitutes].

The aim of this study was to compare in 60 ASA1 patients, the rheological effects of a 500 ml plasma substitute infusion at induction of general anaesthesia. The 60 patients were allocated into 6 groups of 10. Each group received either albumin 4%, or dextran 40 3.5%, or dextran 60 6%, or hydroxyethylstarch (HES) 200 6%, or modified fluid gelatin or Ringer lactate. The infusion extended over 30 minutes. In blood samples obtained before infusion, immediately after the end, three and 24 hours after the end of infusion, osmotic pressure, oncotic pressure, proteins and fibrinogen concentration were measured. Following rheological parameters were also assessed: plasma viscosity, blood viscosity at two shear rates (0.5 and 128 s-1), erythrocyte aggregation by primary and final aggregation times as well as total and partial dissociation thresholds. The determinations were carried out at haematocrit corrected to 40%. At intergroup analysis of the different substitutes compared to albumin 4%, with the exception of Ringer lactate, there was no significant modification of osmotic and oncotic pressures or fibrinogen concentrations. Only gelatin and dextran 60 modified the rheological parameters. The intragroup comparison did not demonstrate significant variations of osmotic and oncotic pressures. Fibrinogen concentrations remained unchanged up to the 24th hours, where they increased as a reaction to surgery. Similar changes of rheological parameters occurred for Ringer lactate, albumin 4% and dextran 40: decrease of plasma viscosity (< 10%) and blood viscosity (< 20% at shear rate of 0.5 s-1), increase of primary aggregation time (30-50%) with decrease of total dissociation threshold (10-20%). These changes ended 24 hours after infusion. Dextran 60 and gelatin elicited a modification of blood rheology until the 24th hour after the end of infusion. Such modifications did not occur with HES. It is concluded that when a rheological effect is required albumin 4% or dextran 40 3.5% should be used.

Albumins↗
PubMed1977

[Formation of high-molecular aggregates between serum amylase and colloidal plasma substitutes (author's transl)].

The distribution of molecular weights of human serum amylase was studied by gel filtration of serum, obtained before and after infusion of the colloidal plasma substitutes hydroxyethyl starch, dextran and gelatin, respectively. Both in serum, drawn after intravenous infusion of hydroxyethyl starch, and in a solution of hydroxyethyl starch with serum we observed a significant increase in the molecular weight of serum amylase. The occurrence of this "macroamylase" may be explained by the formation of aggregates between hydroxyethyl starch and amylase. Because of its high molecular weight the elimination of this, presumably, enzyme-substrate-complex is retarded, thus leading to the observed increase of serum amylase activity. In contrast to these observations concerning hydroxyethyl starch no change in the apparent molecular weight of serum amylase was observed following the infusion of either gelatin or dextran or their solutions with serum.

Amylases↗
PubMed2002

Determining the molar mass of a plasma substitute succinylated gelatin by size exclusion chromatography-multi-angle laser light scattering, sedimentation equilibrium and conventional size exclusion chromatography.

The clinical effectiveness of succinylated gelatin as a plasma substitute depends strongly on its molar mass, determined conventionally by size exclusion chromatography (SEC). This study evaluates different SEC calibration standards in comparison with two independent "absolute" methods for determining the weight average molar mass (M(w)) of a succinylated gelatin sample. SEC calibrated using succinylated gelatin fractions correlated well with size exclusion chromatography-multi-angle laser light scattering (SEC-MALLS) and sedimentation equilibrium whereas SEC calibrated with unmodified gelatin, sodium polystyrene sulfonates or pullulans overestimated M(w) by over 20%. Universal calibration was equivocal. The problems associated with the preparation of succinylated gelatin fractions suggest that an absolute method such as SEC-MALLS may be a more suitable choice for determining the M(w) in succinylated gelatins.

Calibration↗
PubMed1974

Effect of allopurinol on the preservation of ischemic kidneys perfused with plasma or plasma substitutes.

Canine kidneys were autotransplanted into nephrectomized dogs after exposure to room temperature for 40-90 minutes and preservation for 24 hours by hypothermic bloodless pulsatile perfusiin. Three perfusates were used; cryoprecipitated pooled dogs' plasma, human albumin, and human plasmanate. Perfusion after periods of warm ischemia resulted in irreversible renal damage, unless allopurinol was added to the perfusate and fed to the dogs. Thus, metabolic manipulation is capable of protecting tissues in the face of severe ischemic insult, even when using plasma substitutes for perfusion.

Adenosine Triphosphate↗
PubMed1982

Statistical evaluation of plasma substitutes based on 10 variables.

Inasmuch as no single variable is able to predict the outcome or evaluate the effect of various treatments used for resuscitation of shock, a statistical method was applied to evaluate several plasma substitutes by a numerical system based on 10 different hemodynamic and metabolic variables. Shock was induced in 60 dogs by laparatomy and exteriorization of the small intestines. After 3 h, the intestine was returned and the abdomen closed. Fluid infusion was then given during a 20-min period. Measurements were carried out during the next 4 h. Seven therapeutic agents were studied in 7 groups: control (no infusion); Ringer's acetate; gelatin; dextran-40; dextran-70; ACD-plasma; albumin. Variables included: cardiac output, oxygen consumption, plasma volume, hematocrit, skeletal muscle capillary blood flow and permeability surface area, arterial blood pH and base excess, mean arterial blood pressure, and the extravascular water gain. Dextran-40, dextran-70, and albumin restored an average of 7 variables to values above the preshock median value. Gelatin and plasma restored 4 variables and Ringer's acetate restored 3 variables. When no infusion was given, no variable was restored and the animals remained in shock. It is concluded that 3.5% colloid solutions of dextran-40, dextran-70, and albumin are more effective than plasma, gelatin, and Ringer's acetate in this order.

Animals↗
PubMed2001

The gelatin-derived plasma substitute Gelofusine causes low-molecular-weight proteinuria by decreasing tubular protein reabsorption.

PURPOSE: Proteinuria is frequently encountered in patients in the intensive care unit, most likely as a result of renal tubular cell injury. It has been reported that gelatin-derived plasma substitutes contribute to an increase in renal protein excretion. The aim of this study was to investigate the magnitude and the mechanism of the proteinuric effect of Gelofusine, a modified gelatin. MATERIALS AND METHODS: In six healthy male subjects, renal hemodynamics and urinary protein excretion were measured before and after infusion of 330 mL of Gelofusine. RESULTS: Gelofusine had a minor effect on blood pressure, glomerular filtration rate, effective renal plasma flow, and on urinary excretion of immunoglobulin, and albumin. In contrast, there was a major increase in the urinary excretion of the low-molecular-weight proteins beta2-microglobulin (from 0.06 +/- 0.04 to 43.52 +/- 11.75 microg/min; P <.01) and alpha1-microglobulin (from 11 +/- 8 to 72 +/- 24 microg/min; P <.01). The urinary excretion of N-acetyl-beta-D-glucosaminidase (beta-NAG) remained unchanged, suggesting that there was no significant renal tubular cell injury. CONCLUSIONS: When analyzing proteinuria in patients in the intensive care unit it should be considered that Gelofusine increases the urinary excretion of proteins, in particular those of low molecular weight. This effect is most likely due to competitive inhibition of tubular protein reabsorption.

Adult↗
PubMed1979

[The effect of different plasma substitutes on the viscoelastic properties of blood. Comparison with human albumin].

In a previous study the authors proposed a law of visco-elasticity with three parameters to describe the influence on blood of a forced test according Couette's schedule. The changes produced by different plasma substitutes are studied under equilibrium conditions and under altered conditions. Marked changes were noted in the various parameters. It would appear that these changes are related to the cohesion of erythrocyte rouleaux.

Algorithms↗
PubMed1995

Replacement of major surgical blood loss by hypo-oncotic or conventional plasma substitutes.

The purpose of the study was to examine the effects of hypooncotic 4% hydroxyethyl starch 120/0.7, 3% dextran 70, 5% albumin and hyperoncotic 6% hydroxyethyl starch 120/0.7 on the perioperative colloid osmotic pressure (COP), albumin and protein concentrations and fluid balance. The plasma substitutes were used with red cell concentrates to replace blood loss with equal volume in sixty major abdominal or urological surgeries. A special effort was made to keep replacements and losses at even volumes constantly and to avoid fluctuation of blood volume. The blood specimen were obtained before induction, after each 20% blood loss, at the end of the recovery room phase and on the three following postoperative mornings. There were significant differences in the peroperative and immediate postoperative COPs. However, these differences had vanished by the first postoperative morning. COP was preserved above 16 mmHg in all groups throughout the study. The identical peroperative albumin and protein concentrations of the synthetic colloid groups suggests that their volume effect was the same, regardless of the varying COP. During the observation period there were no significant differences among the groups concerning the diuresis and the fluid balances. We conclude, that the hypooncotic 4% HES 120 and 3% dextran 70 solutions provide the same clinical effect as 6% HES 120 solution. Consequently less colloid is needed, which allows the use of greater volumes of the dilute colloid solutions in replacement therapy.

Abdomen↗