A Randomized, Controlled, Double-Blind Crossover Study on the Effects of 1-L Infusions of 6% Hydroxyethyl Starch Suspended in 0.9% Saline (Voluven) and a Balanced Solution (Plasma Volume Redibag) on Blood Volume, Renal Blood Flow Velocity, and Renal Cortical Tissue Perfusion in Healthy Volunteers

Chowdhury, Abeed H.; Cox, Eleanor; Francis, Susan T.; Lobo, Dileep N.

doi:10.1097/sla.0000000000000324

Cited by 49 publications

(47 citation statements)

References 26 publications

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“…Effects of different fluid mixtures have not been studied either. 16,18,19 Adverse outcomes have been reported with the use of isotonic saline in preclinical studies, 23,24 among healthy human volunteers, 25,26 in large observational studies, 18,27,28 and in small RCTs. 19,[29][30][31][32] Studies comparing chloride-liberal IV fluids versus restricted crystalloid solutions (among critically ill patients) suggest potential for adverse outcomes associated with supraphysiologic chloride levels.…”

Section: Discussionmentioning

confidence: 99%

Association Between Initial Fluid Choice and Subsequent In-Hospital Mortality During the Resuscitation of Adults With Septic Shock

Raghunathan

Bonavia

Nathanson

et al. 2016

Survey of Anesthesiology

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Section: Discussionmentioning

confidence: 99%

Association Between Initial Fluid Choice and Subsequent In-Hospital Mortality During the Resuscitation of Adults With Septic Shock

Raghunathan

Bonavia

Nathanson

et al. 2016

Survey of Anesthesiology

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“…A recent study of healthy human volunteers showed a significant reduction in renal artery flow velocity and renal cortical tissue perfusion after infusion of 2 liters of saline over an hour, but not after Plasma-Lyte® infusion(3). A similar trial demonstrated increased renal cortical tissue perfusion with starch solutions prepared in balanced crystalloids rather than saline(13). Saline may diminish renal perfusion by multiple mechanisms.…”

Section: Saline Causes Hyperchloremia Acidosis and Decreased Renal mentioning

confidence: 99%

Saline Is Not the First Choice for Crystalloid Resuscitation Fluids

Semler

Rice

2016

Critical Care Medicine

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“…Compared to 0.9% sodium chloride, Plasma-Lyte 148 ® has been shown to reduce chloride loading 3 ; have an increased buffering capacity 1 ; decrease acute kidney injury, 4 with increases in GFR 4 ; lead to increased renal artery flow rates; 5,6 and reduced mortality in large, postoperative and intraoperative studies in adults. [7][8][9] The use of balanced intravenous (IV) fluids in pediatric medicine is sparse, probably due to the absence of glucose in most balanced crystalloids-an essential part of care for children due to their high metabolic needs.…”

Section: Introductionmentioning

confidence: 99%

Physico‐chemical stability of Plasma‐Lyte 148® and Plasma‐Lyte 148® + 5% Glucose with eight common intravenous medications

Dawson

Wignell

Paul

et al. 2019

Pediatric Anesthesia

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Summary Background Plasma‐Lyte 148® is a balanced, crystalloid intravenous (IV) fluid which is both calcium‐free and isotonic. It prevents the hyperchloremic metabolic acidosis and iatrogenic hyponatremia seen with use of 0.9% sodium chloride and hypotonic solutions, respectively. However, data on compatibility with commonly used drugs are lacking. Aims To investigate the stability of Plasma‐Lyte 148® and Plasma‐Lyte 148® + 5% Glucose with eight commonly used therapeutic agents when compared with 5% glucose and 0.9% sodium chloride as diluents. We aimed to provide vital data which may facilitate the introduction of what appears to be a safer and more economic fluid. Methods Plasma‐Lyte 148® and Plasma‐Lyte 148® + 5% Glucose were mixed with morphine, midazolam, fentanyl, ketamine, clonidine, aminophylline, salbutamol, and furosemide at set concentrations. Comparisons were made to 0.9% sodium chloride and 5% glucose fluid controls. Six repeats of each IV fluid and drug admixture were analyzed through high‐performance liquid chromatography at three time points: 0, 2, and 24 hours. A concentration change of <5% was defined as chemically stable. Physical stability was assessed by observation of precipitate formation or color change. pH changes were measured using a Fisherbrand Hydrus 300 pH meter. Results Relative to starting concentration, all drugs except midazolam were stable to ±3%. All examined therapeutic agents were chemically stable at 2 and 24 hours relative to control solutions. No precipitate formed in any of the samples. All Plasma‐Lyte 148® and Plasma‐Lyte 148® + 5% Glucose drug admixtures remained in a safe, peripheral administration pH range of 5‐9 and were closer to the pH of blood than standard fluid‐drug admixtures. Conclusion Morphine, fentanyl, ketamine, salbutamol, aminophylline, and clonidine are stable for 24 hours when mixed with Plasma‐Lyte 148® and Plasma‐Lyte 148®+5% Glucose for administration at concentrations equivalent to those found at a typical Y‐site with maintenance fluid. Furosemide is stable at lower concentrations than those seen at a Y‐site, but midazolam displayed instability.

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A Randomized, Controlled, Double-Blind Crossover Study on the Effects of 1-L Infusions of 6% Hydroxyethyl Starch Suspended in 0.9% Saline (Voluven) and a Balanced Solution (Plasma Volume Redibag) on Blood Volume, Renal Blood Flow Velocity, and Renal Cortical Tissue Perfusion in Healthy Volunteers

Abstract: There was no difference in the blood volume-expanding properties of the 2 preparations of 6% hydroxyethyl starch. The balanced starch produced an increase in renal cortical tissue perfusion, a phenomenon not seen with starch in 0.9% saline.

Cited by 49 publications

References 26 publications

Association Between Initial Fluid Choice and Subsequent In-Hospital Mortality During the Resuscitation of Adults With Septic Shock

Association Between Initial Fluid Choice and Subsequent In-Hospital Mortality During the Resuscitation of Adults With Septic Shock

Saline Is Not the First Choice for Crystalloid Resuscitation Fluids

Physico‐chemical stability of Plasma‐Lyte 148® and Plasma‐Lyte 148® + 5% Glucose with eight common intravenous medications

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