Blood volume determination using hydroxyethyl starch

Tschaikowsky, K.; Meisner, Michael; Durst, Regine; Rügheimer, Erich

doi:10.1097/00003246-199704000-00008

Cited by 34 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By virtue of its amphiphilic nature, i.e., the presence of both negatively and positively charged groups in the molecule, albumin forms a complete ESL [2, 4, 8, 15]. In contrast, the glycocalyx represents an exclusion zone for large neutral and anionic molecules like dextrans ≥70 kDa [36, 37] and it may be expected that other large molecules carrying an exclusively negative charge, such as HES, also do not interact well with an intact EG. Accordingly, an albumin-containing perfusate should ‘hook’ into this structure, transmitting shear stress to the vessel wall, while artificial colloids like HES, figuratively speaking, brush only against the top of the glycocalyx molecules [38].…”

Section: Discussionmentioning

confidence: 99%

The Endothelial Glycocalyx Prefers Albumin for Evoking Shear Stress-Induced, Nitric Oxide-Mediated Coronary Dilatation

Jacob¹,

Rehm²,

Loetsch³

et al. 2007

J Vasc Res

View full text Add to dashboard Cite

Background: Shear stress induces coronary dilatation via production of nitric oxide (NO). This should involve the endothelial glycocalyx (EG). A greater effect was expected of albumin versus hydroxyethyl starch (HES) perfusion, because albumin seals coronary leaks more effectively than HES in an EG-dependent way. Methods: Isolated hearts (guinea pigs) were perfused at constant pressure with Krebs-Henseleit buffer augmented with 1/3 volume 5% human albumin or 6% HES (200/0.5 or 450/0.7). Coronary flow was also determined after EG digestion (heparinase) and with nitro-L-arginine (NO-L-Ag). Results: Coronary flow (9.50 ± 1.09, 5.10 ± 0.49, 4.87 ± 1.19 and 4.15 ± 0.09 ml/min/g for ‘albumin’, ‘HES 200’, ‘HES 450’ and ‘control’, respectively, n = 5–6) did not correlate with perfusate viscosity (0.83, 1.02, 1.24 and 0.77 cP, respectively). NO-L-Ag and heparinase diminished dilatation by albumin, but not additively. Alone NO-L-Ag suppressed coronary flow during infusion of HES 450. Electron microscopy revealed a coronary EG of 300 nm, reduced to 20 nm after heparinase. Cultured endothelial cells possessed an EG of 20 nm to begin with. Conclusions: Albumin induces greater endothelial shear stress than HES, despite lower viscosity, provided the EG contains negative groups. HES 450 causes some NO-mediated dilatation via even a rudimentary EG. Cultured endothelial cells express only a rudimentary glycocalyx, limiting their usefulness as a model system.

show abstract

Section: Discussionmentioning

confidence: 99%

The Endothelial Glycocalyx Prefers Albumin for Evoking Shear Stress-Induced, Nitric Oxide-Mediated Coronary Dilatation

Jacob¹,

Rehm²,

Loetsch³

et al. 2007

J Vasc Res

View full text Add to dashboard Cite

show abstract

“…32 HES is used clinically for plasma volume expansion in obstetric patients, and has been administered in various clinical trials for this purpose in the obstetric and anesthesia literature. 21, 33-36 The HES method for blood volume estimation is a rapid, safe, and acceptable technique for use in pregnant patients, and does not cross the placenta.…”

Section: Methodsmentioning

confidence: 99%

“…21, 33-36 The HES method for blood volume estimation is a rapid, safe, and acceptable technique for use in pregnant patients, and does not cross the placenta. 32,33,37,38 …”

Section: Methodsmentioning

confidence: 99%

“…Proposed by Tschaikowsky et al 32 in 1997, the HES method uses hydroxyethyl starch as a dilution marker and calculates blood volume from the difference of glucose concentration obtained by acid hydrolysis of plasma before and after injection of HES. 39,40 Blood samples are collected before and after intravenous injection of HES.…”

Section: Methodsmentioning

confidence: 99%

“…We sought to compare the total and relative blood volume of obese and lean gravidas near term using a dilution technique based on the colloid volume expander, Hydroxyethyl Starch (HES). 32 We also sought to compare these calculations to blood volume estimates based on weight alone. 7 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Blood volume determination in obese and normal-weight gravidas: the hydroxyethyl starch method

Vricella

Louis

Chien

et al. 2015

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective The impact of obesity on maternal blood volume in pregnancy has not been reported. We compared the blood volumes of obese and normal weight gravidas using a validated Hydroxyethyl Starch (HES) dilution technique for blood volume estimation. Study Design Blood volumes were estimated in 30 normal weight (pregravid body mass index; BMI < 25 kg/ m2) and 30 obese (pregravid BMI > 35 kg/m2) gravidas after 34 weeks gestation using a modified HES dilution technique. Blood samples obtained before and 10 minutes after HES injection were analyzed for plasma glucose concentrations after acid hydrolysis of HES. Blood volume was calculated from the difference between glucose concentrations measured in hydrolyzed plasma. Results Obese gravidas had higher pregravid and visit BMI (mean [Std Dev]): pregravid (41[4] vs 22[2] kg/m2, p=0.001); visit BMI (42[4] vs 27[2] kg/m2, p=0.001), but lower weight gain (5[7] vs. 12[4] kg, p=0.001) than normal weight women. Obese gravidas had similar estimated total blood volume to normal weight women (8103 ± 2452 vs. 6944 ± 2830 mL, p = 0.1), but lower blood volume per kilogram weight (73 ± 22 vs. 95 ± 30 mL/kg, p = 0.007). Conclusion Obese gravidas have similar circulating blood volume, but lower blood volume per kilogram body weight, than normal weight gravidas near term.

show abstract

Assessment of venous hemodynamics and volume homeostasis during pregnancy: recommendations of the International Working Group on Maternal Hemodynamics

Gyselaers

Spaanderman

2018

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Venous hemodynamics and volume homeostasis are important aspects of cardiovascular physiology. However, today their relevance is still very much underappreciated. Their most important role is maintenance and control of venous return and, as such, cardiac output. A high-flow/low-resistance circulation, remaining constant under physiological circumstances, is mandatory for an uncomplicated course of pregnancy. In this article, characteristics of normal and abnormal venous and volume regulating functions are discussed with respect to normal and pathologic outcomes of pregnancy, and current (non-invasive) methods to assess these functions are summarized. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

Blood volume determination using hydroxyethyl starch

Abstract: Blood volume determination by the hydroxyethyl starch method is accurate and rapid and may enhance perioperative monitoring of fluid and blood therapy.

Cited by 34 publications

References 18 publications

The Endothelial Glycocalyx Prefers Albumin for Evoking Shear Stress-Induced, Nitric Oxide-Mediated Coronary Dilatation

The Endothelial Glycocalyx Prefers Albumin for Evoking Shear Stress-Induced, Nitric Oxide-Mediated Coronary Dilatation

Blood volume determination in obese and normal-weight gravidas: the hydroxyethyl starch method

Assessment of venous hemodynamics and volume homeostasis during pregnancy: recommendations of the International Working Group on Maternal Hemodynamics

Contact Info

Product

Resources

About