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At least 19 recordsLinked to original sources
PubMed1985

Blood and plasma substitutes--plasma expansion and oxygen transport properties.

Because of the risks and costs of blood and blood product infusion, developing blood and plasma substitutes is of significance. Two currently utilized substances, dextran and hydroxyethyl starch, are effective colloid plasma expanders. The dextrans have properties that improve microcirculatory blood flow but are associated with several possible adverse effects. Hydroxyethyl starch is a well-tolerated agent that has efficacy similar to albumin but at a lower cost. Two newer substances, perfluorocarbons and stroma-free hemoglobin, are being developed to improve oxygen transport as well as plasma expansion.

Blood Substitutes↗
PubMed1985

Plasma exchange-induced biological stress of the Hagemann-mediated systems: results of contact activation and plasma substitution.

Plasma exchange can induce changes in the biological systems of coagulation, fibrinolysis, complement and kinins, either by contact activation or plasma substitution. In order to know which of the two is responsible, the actual initial and final values and theoretical calculated final values were compared. Fibrinogen, Antithrombin III and platelets fell more than expected, and there was a significant increase in Platelet-Factor four and Betathromboglobulin which was greater than would produced by plasma substitution alone. Fibrinolysis is shortened and white cells rise. Complement and kinins were not significantly changed. During plasma exchange, contact activation actually triggers coagulo-fibrinolytic pathway and stresses cellular components.

Adult↗
PubMed1981

Independence of reciprocal attachment sites on denatured collagen and fibronectin from antigenic sites, and binding of gelatin-based plasma substitutes to plasma fibronectin.

Fibronectin and denatured collagen possess attachment sites for each other and, in addition, antigenic sites reacting with the respective antibodies. Using an enzyme linked immunosorbent assay it was shown that attachment sites and antigenic sites on fibronectin and on collagen reacted independently of each other. Gelatin-based plasma substitutes blocked the binding of fibronectin to denatured collagen thus showing that attachment sites for fibronectin are preserved in the gelatin preparations used for manufacturing these plasma substitutes. Antigenic sites, in contrast, were destroyed during the manufacturing process as shown with antibodies to denatured collagen raised in guinea-pigs. It is concluded that complex formation of gelatin-based plasma substitutes with plasma fibronectin may occur upon infusion of such plasma substitutes but that formation of antigen/antibody complexes in vivo is unlikely.

Animals↗
PubMed1990

Effects of different plasma substitutes on plasma fibronectin concentrations in patients undergoing abdominal surgery.

Plasma fibronectin is important for host defences as an opsonin of the mononuclear phagocyte system (MPS). The effects of three types of plasma substitutes, crystalloid, gelatin and dextran solutions, on plasma fibronectin levels were studied in patients undergoing abdominal surgery in relation to serum total protein and serum C-reactive protein (CRP) levels. Plasma fibronectin levels decreased during induction of anaesthesia and infusion of an electrolyte solution before infusion of the plasma substitute, and they were further decreased during operation after infusion of plasma substitutes and remained depressed on the first postoperative day in all study groups (P less than 0.05-0.01). In the crystalloid and dextran groups, plasma fibronectin levels exceeded preoperative levels by the 4th-5th postoperative day (P less than 0.05-0.01), but in the gelatin solution group they remained depressed (P less than 0.01). Serum total protein levels remained lower than preoperative values throughout the study period (P less than 0.05-0.01), whereas CRP levels were many times higher on days 1 and 4-5 postoperatively in all groups (P less than 0.01).

Abdomen↗
PubMed1989

[The problems of plasma substitution in performing therapeutic plasmapheresis (an evaluation of the efficacy of plasma substitute media and the methods for obtaining them)].

The analysis of 3700 plasmaphereses (AP) performed in 692 patients permitted the authors to develop the basic principles and policy of plasma substitution for various groups of patients. The use of protein preparations and fresh frozen plasma is believed essential in intensive plasmapheresis in patients with immunomediated disorders and DIC syndrome, respectively. Potentialities of selective therapeutic PA are discussed. PA criteria should be based on the patient's state, therapeutic aims, circulation parameters, laboratory data.

Blood Donors↗
PubMed1987

[Binding of drugs to artificial plasma substitutes].

The binding of different drugs to plasma proteins as well as the binding to other structures (e.g. dialysis membranes, i.v. delivery sets) is well documented and of therapeutic importance. Colloid solutions of macromolecules are widely used as plasma substitutes and plasma expanders. A possible binding of drugs to these macromolecules was investigated by means of equilibrium dialysis. Benzodiazepines, beta-blockers, cardiac glycosides, local anesthetics, non steroidal antiinflammatory drugs, glibenclamide, phenobarbitone and phenprocoumon (10(-7) in 50 mM tris buffer, pH 7.4) were dialyzed against tris buffer diluted (1:5) commercially available plasma substitutes consisting of hydroxyethyl starch (HES), dextran, gelatine and polyvinylpyrrolidone (PVP). Binding to plasma substitutes was observed with the highest values for penbutolol and oxypolygelatine (41%), digitoxin and HES 200 (35%), phenprocoumon and PVP (43%). It is concluded that the binding of drugs to plasma substitutes is in most cases negligible and not of clinical relevance. Since some drugs seem to bind to some extent to different macromolecules this should be borne in mind and could be of some influence e.g. in perfusion experiments with isolated organs.

Chemical Phenomena↗
PubMed1995

[Outcome of the use of albumin and colloid plasma substitutes from 1989 to 1993 in a French University Hospital Center].

OBJECTIVES: To evaluate the use of plasma substitutes (albumin, gelatins, dextrans, starches) from 1989 to 1993 in a 3000-bed University hospital and to assess the impact of the 1989 consensus conference of the French speaking Society of Intensive Care Medicine on the choice of plasma substitutes for treatment of hypovolaemia. STUDY DESIGN: Retrospective study of a case series. METHODS: Data on the use of albumin and artificial plasma substitutes were obtained from Blood Bank and Pharmacy. RESULTS: Between 1989 and 1993, the total amount of administered plasma substitutes decreased by 20%, allowing a saving of 1.7 million FF. There was a 60% decrease in the use of gelatins and dextrans. The starches, introduced in 1991, became in 1993 the most used plasma substitute, with 37% of the total. The use of albumin showed only a 32% decrease and was still in 1993 the main source of expenditure for plasma substitutes, with 3.8 million FF and 80% of the total cost. The number of plasmapheresis increased by 15%, whereas the use of albumin for plasmapheresis, almost constant in absolute value, increased from 31% in 1989 to 45% in 1993 of the total expenses. There were large differences between the services regarding the use of albumin. Intensive care and surgical units represented 70% of the total (plasmapheresis excluded). In this group, the overall fall of use was 22%, some units obtaining a 93% decrease whereas other did not change in spite of constant admission numbers. Medical units decreased their albumin use by 53%. CONCLUSION: The decrease in the albumin use between 1989 and 1993 was not significant. The impact of the consensus conference, if any, was weak. A careful evaluation of the prescriptions would be necessary to improve the compliance of clinical practice with recommendations by the consensus conference.

Albumins↗
PubMed1975

Plasma substitute induced impairment of the reticuloendothelial system function.

Currently used plasma substitutes are large colloids and are partly engulfed by reticuloendothelial (RE) cells. This study was designed to investigate the magnitude and duration of the possible RES dysfunction induced by plasma substitutes. The following substances were studied in both normal and burned (LD-10) CBA mice: allogen albumin 3%, and commercial preparations of dextran 40, dextran 70, hydroxyethyl starch, gelatin and PVP. Infusion volume was 20 ml/kg and i.v. infusion time 1 hour. Animals given allogen plasma served as controls. One, 3 and 6 hours after the i.v. injection of 51-Cr-rabbit RBC, we determined the disappearance rate, and uptake and distribution of the 51-Cr-RBC in the main RES organs (liver, spleen and lungs). In normal mice the disappearance rate was significantly decreased one and three hours post infusion, while it was decreased even after 6 hours in burned mice. Groups given albumin or plasma stayed close to non-infused animals. In order to clarify the physiologic significance of these findings we used another test substance known to be handled by the RES. Salmonella enteritidis endotoxin was tested with regard both to toxicity and rate of elimination. The toxicity, after i.p. injection, was significantly intensified both one and 3 hours post-infusion in normal mice. In burned mice toxicity became even more intense. The ability to eliminate 51-Cr-labelled endotoxin was significantly decreased following infusion in both normal and burned mice, one as well as three hours later. The in vitro liver phagocytosis was tested utilizing the liver slice technique. Standardized slices were incubated in Krebs-Ringer buffer together with 125-I-HSA aggregates as RES test substance with and without plasma from mice given plasma substitute infusions. Allogen plasma enhanced the phagocytic uptake (four times), while post-infusion plasma did not. It is concluded from these experiments, utilizing two different RES test substances in both normal and hypovolemic animals, that the plasma expanders tested do impair RES phagocytosis. The mechanism seems to be an interaction with phagocytosis-promoting plasma factors. Even though this impairment is temporary, it may jeopardize such important RES functions as elimination of microorganisms, toxins, cell debris and tumour cells, or spoil the afferent limb of the immune response to many antigens.

Animals↗
PubMed1979

[Effect of kidney function on the elimination and action of colloidal plasma substitutes].

Hypovolemia and prophylaxis of thrombosis are the main indications for colloidal plasma substitutes. This is also true for patients with renal failure. Due to their difference in molecular structure colloidal plasma substitutes, which are in clinical use--dextran, hydroxyethyl starch, gelatin--, are eliminated tbrough different pathways. However, the kidney plays an important role in the elimination of all three substances. Therefore pharmacokinetics and pharmacodynamics of colloidal plasma substitutes, which are based on dextran, hydroxyethyl starch and gelatin, were studied in patients with normal or impaired renal function. Renal insufficiency proved to affect the elimination and therapeutic efficacy of these colloids in different and characteristic ways. Consequently this requires special indications and dosage recommendations for patients with renal insufficiency.

Anuria↗