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PubMed1989

[Plasma substitutes and normovolemic hemodilution].

Normovolemic hemodilution is an interesting technique for blood sparing during the operative period. Rheologic and hemodynamic advantages of this technique are stressed as well as its indications and limits. A normovolemic status sustained all along the hemodilution period is mandatory in order to maintain adequate cardiac output and oxygen transport. Discussing the respective properties of plasma substitutes allows to define which amount of substitute has to be given to avoid an hypovolemic status during hemodilution.

Blood Coagulation Factors↗
PubMed1985

Characterization of a modified, stroma-free hemoglobin solution as an oxygen-carrying plasma substitute.

A new infusion solution prepared from stroma-free, crosslinked and pyridoxalated hemoglobin is described. The characteristics of which have been adapted to the functions of native, intra-erythrocyte hemoglobin. The solution contains 8.5 per cent weight per volume of glutardialdehyde modified hemoglobin with a mean molecular weight (Mn) of 200,000 Dalton. The non-crosslinked fraction constitutes 15 per cent of the total hemoglobin. The p50 of 27 torr at pH 7.4 (plasma pH) corresponds to the value for the intra-erythrocyte hemoglobin at pH 7.25. The oncotic pressure is adjusted to 28 torr by the addition of 2.5 per cent weight per volume of human albumin. The methemoglobin content is less than 5 per cent of the total hemoglobin and remains constant for one year. The relative viscosity of the 8.5 per cent hemoglobin solution is 3.0 and, thus, is lower than the viscosity of blood. The intravascular half-life was determined in chimpanzees as about 16 hours. On the basis of available data, this hemoglobin solution may be suitable for clinical use as oxygen carrying plasma substitute.

Biological Transport↗
PubMedDate not supplied

[Production of a plasma substitute with hemodynamic properties based on modified globin of human erythrocytes].

The developed parameters for hemolyzate acid-base treatment in the presence of hydrogen peroxide with the subsequent ethanol fractionation made it possible to suggest a method for isolating a modified globin from erythrocytes of donor blood stored for different time. The method is of applied significance because it permits production not only of a new effective plasma substitute of the hemodynamic action but also contributes considerably to solution of the problem of the donor blood erythrocytes utilization.

Blood Donors↗
PubMed1974

Difficulty in blood typing after infusion of plasma substitutes. Relationship to erythrocyte sedimentation rate and rouleaux-formation.

Recently we experienced one incident that the patient with A blood type reacted as AB type on macroscopic observation when the blood type was tested immediately after the infusion with Dextran70 in saline. The patient was confirmed as having the A type by reexamination later. Subsequently 90 cases were subjected to blood typing following infusion with one of the seven plasma substitutes such as dextran, MF-gelatin and HE-starch. One patient demonstrated an abnormal reaction. She had marked acceleration of erythrocyte sedimentation rate (E.S.R.) and positive serological reactions for syphilis before the infusion with Dextran70. It was thought that the rapid increase in high molecular colloids in circulation accelerated rouleaux formation and caused the change in agglutination thus resulted in misjudgement of blood typing.

ABO Blood-Group System↗
PubMed1978

Alterations in brain and muscle oxygenation during hypovolemia and replacement with plasma substitutes in rats.

A study was conducted on the effects of mild hemorrhage-induced hypovolemia and subsequent replacement with lactated Ringer's dextran or hemoglobin solution in 52 pentobarbital-anesthesized rats. Blood loss of 1.25% of body weight had no significant effect on the blood flow or relative tissue PO2 of the white matter of the cerebral cortex. Blood flow and relative tissue PO2 of the biceps brachii muscle were lowered during hypovolemia. Volume replacement with any of the three plasma substitutes had no effect on blood flow or relative tissue PO2 of cortical white matter. They all caused partial restoration of blood flow and relative tissue PO2 in the biceps brachii muscle. Full return in the muscle was not achieved, nor were there any significant differences between the treatment groups.

Animals↗
PubMed1992

[Tissue reactions in children treated with hemodynamic dextran and detoxication polyvinylpyrrolidone plasma substitutes].

By means of light and electron microscopy tissue reactions produced by repeated use of polyvinylpyrrolidone (PVP) and dextran plasma substitutes are studied on the material of 20 autopsies and 4 biopsies as well as in 65 experimental cases. Delayed type of PVP accumulation in tissues after the hemodes administration is determined as well as its dependence on the dose, time, kidney function and the presence of inflammatory foci. The differences in tissue reactions after administration of dextran and PVP substitutes are established. The results indicate that medicinal thesaurismosis may develop only after repeated infusions of PVP substitutes, while dextran accumulation is of a transitory type and results in characteristic morphological changes in the renal epithelium only.

Adolescent↗
PubMed1975

[Indications for plasma substitutes].

During severe hemorrhage the O-2-transport capacity of blood is reduced due to the loss of hemoglobin. This reduction is, however, fully compensated down to 25% hematocrit by augmentation of the minute volume consequent on the decrease of blood viscosity due to hemodilution, though this holds only on condition that myocardial contractibility and total blood volume are not impaired. The compensation of lost intravasal fluid is therefore prevailing importance, but the substitute need not be blood and may consist of a suitable colloid solution. Physiogel, a modified fluid gelatin, has proved to be excellent for this primary substitution of blood losses. The plasma derivatives should be reserved for special indications, particularly for treatment of oncotic deficit, and here highly concentrated (10-20% albumin) preparations are needed. Blood transfusions are indicated when the hemoglobin content falls below the critical limit of 25% hematocrit.

Blood Coagulation↗
PubMed1976

[The influence of different plasma substitutes on blood clotting in isovolaemic haemodilution (author's transl)].

In a clinical study, the influence of 6 per cent Dextran 60 and 6 per cent hydroxyethyl starch (HES) on blood clotting was measured in 2 comparable groups of surgical patients. Haematocrit, platelets, thromboplastin time according to Quick, partial thromboplastin time and fibrinogen level were determined before and after isovolaemic haemodilution, and subsequently during a period of 14 days. There was no significant difference between the diluents with regard to their effect on blood clotting. Changes within each group may be ascribed to the diluting effect of the plasma substitutes.

Blood Cell Count↗
PubMed1989

[Intra- and postoperative effect of various plasma substitutes on blood rheology and conjunctival oxygen partial pressure in microsurgical intervertebral disk operations].

In a prospective, randomized, controlled, parallel group study the effect of different infusion solutions (HES 200/0.5 10%, dextran 40 10% and electrolyte solution) during and after intervertebral disc microsurgery on blood fluidity and conjunctival partial oxygen pressure was measured. At the beginning of the operation all patients showed a reduction in conjunctival oxygen pressure - independent of the infusion solution. Both fluidity of blood and oxygen partial pressure changed according to the plasma substitute used. Thus after the administration of medium molecular weight hydroxyethyl starch an improvement in the fluidity of blood with a consecutive significant increase in the conjunctival oxygen pressure could be observed, whereas there was no increase after the administration of electrolyte solution and only a slight one (according to tendency) after infusion of dextran.

Adult↗
PubMed1977

[Hydroxy-ethyl-starch as plasma substitute in transurethral prostatectomy with the "cold-punch" method (author's transl)].

Each of 24 patients undergoing transurethral prostatectomy under spinal anaesthesia received 1000 ml HES and, depending from the clinical situation, some patients received blood-transfusion. Afterwards two groups were formed: group A (11 patients), who received HES only, and group B (13 Patients) with additional blood-transfusions. The following parameters were monitored simultaneously: blood pressure, heart rate, stroke index, cardiac output, active blood volume, hemoglobin and hematocrit in whole blood as well as in the irrigatin fluid of the bladder. They showed HES to be a useful plasma substitute for older patients. It is well tolerated and has a slow stabilising effect on circulation, which was effective for several hours. Furthermore, HES-infusion reduced the average need of bloodtransfusion by 500 ml.

Aged↗