Effect of blood pressure on plasma volume loss in the rat under increased permeability

Dubniks, Maris; Persson, Johan; Grände, Per‐Olof

doi:10.1007/s00134-007-0756-2

Cited by 41 publications

(31 citation statements)

References 33 publications

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“…The loss of plasma fluid at an increased hydrostatic capillary will be still larger at a state of increased permeability. This theory has been confirmed both experimentally and clinically (Dubniks et al, 2007;Nygren et al, 2010).…”

Section: Principles Of Transcapillary Exchange In Tissues Outside Thesupporting

confidence: 60%

“…Vasoconstrictors may also have extracranial side effects, such as acute respiratory distress syndrome (ARDS) (Robertson et al, 1999;Contant et al, 2001), and they may cause increased general leakage of plasma, resulting in hypovolemia and general tissue oedema (Dubniks et al, 2007;Nygren et al, 2010). This type of side effect can be reduced by accepting a lower CPP than the initially recommended lowest CPP of 70 mmHg (Bullock et al, 1996;Bullock et al, 2000), and by avoiding or limiting the use of vasopressors.…”

Section: Treatment Of Icpmentioning

confidence: 99%

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Severe traumatic brain injury management and clinical outcome using the Lund concept

2014

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Section: Principles Of Transcapillary Exchange In Tissues Outside Thesupporting

confidence: 60%

Section: Treatment Of Icpmentioning

confidence: 99%

Severe traumatic brain injury management and clinical outcome using the Lund concept

2014

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“…This may result in transcapillary leakage and hypovolemia. 28) Under this condition, correction of low plasma volume therefore may be essential to maintain adequate organ perfusion and oxygen delivery. 29) For decades there has been debates regarding which kind of plasma expander should be infused.…”

Section: Discussionmentioning

confidence: 99%

Site-Specific Chemical Modification of Human Serum Albumin with Polyethylene Glycol Prolongs Half-life and Improves Intravascular Retention in Mice

Zhao

Cheng

Tan

et al. 2012

Biological & Pharmaceutical Bulletin

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Human serum albumin (HSA) is used as an important plasma volume expander in clinical practice. However, the infused HSA may extravasate into the interstitial space and induce peripheral edema in treating the critical illness related to marked increase in capillary permeability. Such poor intravascular retention also demands a frequent administration of HSA. We hypothesize that increasing the molecular weight of HSA by PEGylation may be a potential approach to decrease capillary permeability of HSA. In the present study, HSA was PEGylated in a site-specific manner and the PEGylated HSA carrying one chain of polyethylene glycol (PEG) (20 kDa) per HSA molecule was obtained. The purity, PEGylated site and secondary structure of the modified protein were characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), thiol group blockage method and circular dichroism (CD) measurement, respectively. In addition, the pharmacokinetics in normal mice was investigated, vascular permeability of the PEGylated HSA was evaluated in lipopolysaccharide (LPS)-induced lung injury mouse model and the pharmacodynamics was investigated in LPS-induced sepsis model with systemic capillary leakage. The results showed that the biological half-life of the modified HSA was approximately 2.3 times of that of the native HSA, PEG-HSA had a lower vascular permeability and better recovery in blood pressure and haemodilution was observed in rats treated with PEG-HSA. From the results it can be inferred that the chemically well-defined and molecularly homogeneous PEGylated HSA is superior to HSA in treating capillary permeability increase related illness because of its longer biological half-life and lower vascular permeability.

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“…The latter may influence permeability and transcapillary hydrostatic pressures, which in turn may differentially influence the plasma-volume-expanding properties of colloids and crystalloids. 20 Normal transcapillary escape of albumin in humans is approximately 5% per hour in healthy subjects and is reported to increase to approximately 15% per hour in sepsis, and corresponding values in the rat are 15% per hour and 20% per hour, respectively. 11,21 These differences in transcapillary escape of albumin suggest that also species differences may be of importance for the clinical relevance of this study.…”

mentioning

confidence: 99%

Plasma Volume Expansion with 5% Albumin Compared to Ringer’s Acetate during Normal and Increased Microvascular Permeability in the Rat

2014

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• It is thought that the better volume-expanding effect of albumin relative to crystalloids is dependent on low endothelial permeability for albumin What This Article Tells Us That Is New• One group of animals were subjected to a 11% hemorrhage and then given either 5% albumin in a volume equal to the shed blood volume or Ringer's acetate at 4.5 times that volume • Another group of animals were subjected to abdominal sepsis, and at 3 h, measured plasma volume loss was replaced with either 5% albumin or with Ringer's acetate in 4.5 times the measured loss • Plasma volume expansion with albumin relative to Ringer's acetate did not differ between the two groups despite different etiologies for the decrease in plasma volume ABSTRACT Background: It is believed that the effectiveness of colloids as plasma volume expanders is dependent on the endothelial permeability for macromolecules. The objective of this study was to test the hypothesis that the plasma volume expanding effect of 5% albumin relative to that of a crystalloid solution is reduced if microvascular permeability is increased. Methods: A control group was resuscitated with either 5% albumin (8 ml/kg) or Ringer's acetate (36 ml/kg) immediately after a hemorrhage of 8 ml/kg (n = 29). In a second group, permeability was increased by inducing sepsis through cecal ligation and incision (n = 28). Three hours after cecal ligation and incision, the animals were resuscitated with either 5% albumin in a ratio of 1:1 relative to the volume of lost plasma, or Ringer's acetate in a ratio of 4.5:1. Results: In the hemorrhage group, plasma volumes at 15 min after resuscitation with albumin or Ringer's acetate had increased by 9.8 ± 2.6 ml/kg (mean ± SD) and 7.4 ± 2.9 ml/kg and were similar at 2 and 4 h. Plasma volume 3 h after cecal ligation and incision had decreased by approximately 7 ml/kg, and at 15 min after resuscitation with albumin or Ringer's acetate it had increased by 5.7 ± 2.9 and 2.4 ± 3.0 ml/kg, respectively (P < 0.05). At 2 and 4 h after resuscitation, plasma volumes did not differ between the groups. Conclusion: This study does not support the hypothesis that the plasma-volume-expanding effect of albumin relative to that of crystalloids is decreased under conditions characterized by increased permeability. ( Anesthesiology 2014; 121:817-24)The first two authors contributed equally to the study.

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Effect of blood pressure on plasma volume loss in the rat under increased permeability

Cited by 41 publications

References 33 publications

Severe traumatic brain injury management and clinical outcome using the Lund concept

Severe traumatic brain injury management and clinical outcome using the Lund concept

Site-Specific Chemical Modification of Human Serum Albumin with Polyethylene Glycol Prolongs Half-life and Improves Intravascular Retention in Mice

Plasma Volume Expansion with 5% Albumin Compared to Ringer’s Acetate during Normal and Increased Microvascular Permeability in the Rat

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