Changes in Intravascular Volume During Acute Normovolemic Hemodilution and Intraoperative Retransfusion in Patients with Radical Hysterectomy

Rehm, Markus; Orth, Victoria; Kreimeier, U.; Thiel, Manfred; Haller, M.; Brechtelsbauer, H.; Finsterer, U

doi:10.1097/00132586-200012000-00051

Cited by 21 publications

(37 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All tested iso-oncotic solutions, by contrast, remained almost completely within the circulatory compartment if infused to replace losses by acute bleeding [35].…”

Section: Fluid Physiology Meets Clinical Practice: the Truth About Vomentioning

confidence: 99%

“…In principle, two different model situations are of interest when intravenously applying i.v. fluids: infusion to maintain or restore blood volume in the context of acute bleeding, that is, when the system is in need of volume (clinical model: acute normovolaemic haemodilution -ANH [35]) and infusion in order to expand blood volume beyond intravascular normovolaemia, that is, when the system is not in need of volume (clinical model: hypervolaemic haemodilution [36]). Whereas the clinical impression including changes in haematocrit is occasionally misleading [37], only the combination of haemodilutional measures with direct assessment of the blood volume before and after can determine the intravascular volume effect.…”

Section: Fluid Physiology Meets Clinical Practice: the Truth About Vomentioning

confidence: 99%

See 1 more Smart Citation

Reappraising Starling

Jacob

Chappell

2013

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of reviewVascular permeability is traditionally explained by Starling's principle, describing two opposing forces across the endothelial cell line to maintain compartments in balance. Several contradictions to this principle have recently questioned its validity. Recent findingsHydraulic conductivity is kept low by a properly working endothelial surface layer, created by binding and intercalating plasma constituents with the structural elements of an endothelial glycocalyx. Limiting fluid filtration is not closely related to the interstitial protein concentration. Rather, the oncotic pressure difference pertinent to fluid homeostasis is built up between the intravascular space and a small protein-free zone beneath the protein-loaded endothelial glycocalyx. This crucial structure, and therefore the resistance of the barrier against outflow of large molecules, is endangered by ischaemia, inflammation and intravascular hypervolaemia. An intact endothelial surface layer retains iso-oncotic preparations of large molecules infused to compensate for acute bleeding. Crystalloids cannot be held back sufficiently, even if preload is warranted. SummaryStarling's principle requires an adaptation to recognize that there is no inward-directed oncotic pressure gradient across the whole anatomical vessel wall. The carrier of vascular barrier competence is the intact endothelial surface layer which might be protected by avoiding intravascular hypervolaemia and limiting inflammation.

show abstract

“…All tested iso-oncotic solutions, by contrast, remained almost completely within the circulatory compartment if infused to replace losses by acute bleeding [35].…”

Section: Fluid Physiology Meets Clinical Practice: the Truth About Vomentioning

confidence: 99%

Section: Fluid Physiology Meets Clinical Practice: the Truth About Vomentioning

confidence: 99%

Reappraising Starling

Jacob

Chappell

2013

Current Opinion in Critical Care

View full text Add to dashboard Cite

show abstract

“…The most reliable method for investigating the actual volume effect has proved to be direct measurement of blood volume before and after the application of an infusion solution (. Table 2; [8,14,[16][17][18][19][20]). The crucial pharmacodynamic property of the colloids is their relatively large volume effect [8].…”

Section: In Order To Develop a Viable Strategy To Replace All Of Thesmentioning

confidence: 99%

State of the art in fluid and volume therapy

et al. 2017

View full text Add to dashboard Cite

“…The peak even persists up to 72 hours after trauma or surgery. The common explanation for this phenomenon is a fluid shift into the so-called third space [53,54].…”

Section: Clinical Considerationsmentioning

confidence: 99%