Effects of anesthesia on fluid volume kinetics after infusion of colloid solution during blood donation

Lee, Eun‐Ho; Kim, Sun-Key; Yeo, Young Goo; Choi, Kyu Taek

doi:10.4097/kjae.2010.58.6.514

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Therefore, we could not adopt the two-volume model to explain the plasma dilution induced by administration of colloid solutions. In previous studies, the volume kinetics of colloid solutions were also described through the one-volume model 2,19 .…”

Section: Discussionmentioning

confidence: 99%

Population-based volume kinetics of crystalloids and colloids in healthy volunteers

Bang

Choi

et al. 2019

Sci Rep

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We characterized the volume kinetics of crystalloid solutions (Ringer’s lactate solution and 5% dextrose water) and colloid solutions (6% tetrastarch and 10% pentastarch) by nonlinear mixed-effects modeling in healthy volunteers. We also assessed whether the bioelectrical impedance analysis parameters are significant covariates for volume kinetic parameters. Twelve male volunteers were randomly allocated to four groups, and each group received the four fluid solutions in specified sequences, separated by 1-week intervals to avoid any carryover effects. Volunteers received 40 ml/kg Ringer’s lactate solution, 20 ml/kg 5% dextrose water, 1000 ml 6% tetrastarch, and 1000 ml 10% pentastarch over 1 h. Arterial blood samples were collected to measure the hemoglobin concentration at different time points. Bioelectrical impedance spectroscopy (BIS, INBODY S10, InBody CO., LTD, Seoul, Korea) was also carried out at preset time points. In total, 671 hemoglobin-derived plasma dilution data points were used to determine the volume kinetic characteristics of each fluid. The changes in plasma dilution induced by administration of crystalloid and colloid solutions were well-described by the two-volume and one-volume models, respectively. Extracellular water was a significant covariate for the peripheral volume of distribution at baseline in the volume kinetic model of Ringer’s lactate solution. When the same amount was administered, the colloid solutions had ~4 times more plasma expansion effect than did the crystalloid solutions. Starches with larger molecular weights maintained the volume expansion effect longer than those with smaller molecular weights.

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Section: Discussionmentioning

confidence: 99%

Population-based volume kinetics of crystalloids and colloids in healthy volunteers

Bang

Choi

et al. 2019

Sci Rep

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“…9 In contrast, a volume kinetic experiment in volunteers undergoing euvolaemic haemodilution with hydroxyethyl starch found that the elimination rate constant from central to peripheral fluid compartments was not reduced, as is the case for ISS, but increased during anaesthesia compared with awake subjects. 98 The duration of resuscitation attributable to hydroxyethyl starch after removal of a unit of blood was therefore shorter in subjects during desflurane anaesthesia.…”

Section: Plasma Substitutesmentioning

confidence: 97%

Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy

Woodcock

2012

British Journal of Anaesthesia

638

530

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I.V. fluid therapy does not result in the extracellular volume distribution expected from Starling's original model of semi-permeable capillaries subject to hydrostatic and oncotic pressure gradients within the extracellular fluid. Fluid therapy to support the circulation relies on applying a physiological paradigm that better explains clinical and research observations. The revised Starling equation based on recent research considers the contributions of the endothelial glycocalyx layer (EGL), the endothelial basement membrane, and the extracellular matrix. The characteristics of capillaries in various tissues are reviewed and some clinical corollaries considered. The oncotic pressure difference across the EGL opposes, but does not reverse, the filtration rate (the 'no absorption' rule) and is an important feature of the revised paradigm and highlights the limitations of attempting to prevent or treat oedema by transfusing colloids. Filtered fluid returns to the circulation as lymph. The EGL excludes larger molecules and occupies a substantial volume of the intravascular space and therefore requires a new interpretation of dilution studies of blood volume and the speculation that protection or restoration of the EGL might be an important therapeutic goal. An explanation for the phenomenon of context sensitivity of fluid volume kinetics is offered, and the proposal that crystalloid resuscitation from low capillary pressures is rational. Any potential advantage of plasma or plasma substitutes over crystalloids for volume expansion only manifests itself at higher capillary pressures.

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“…This is supported by findings indicating less early fluid extravasation in anesthetized compared to non-anesthetized patients receiving equal crystalloid volume loads [ 16 ]–[ 18 ], presumably due to vascular relaxation and concomitant lower perfusion pressures rather than choice of anesthetic agent [ 19 ]. In contrast, the degree of fluid extravasation following FFP infusion is largely unknown, but results from similar experiments using artificial colloids suggest that fluids extravasation may actually be increased during anesthesia [ 20 ]. The increased colloid osmotic pressure of FFP compared with NS may, however, counteract extravasation in the FFP groups with a resulting smaller difference in the hemodynamic response between bolus and slow resuscitation groups.…”

Section: Discussionmentioning

confidence: 99%

Resuscitation speed affects brain injury in a large animal model of traumatic brain injury and shock

Sillesen

Jin

Johansson

et al. 2014

Scand J Trauma Resusc Emerg Med

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BackgroundOptimal fluid resuscitation strategy following combined traumatic brain injury (TBI) and hemorrhagic shock (HS) remain controversial and the effect of resuscitation infusion speed on outcome is not well known. We have previously reported that bolus infusion of fresh frozen plasma (FFP) protects the brain compared with bolus infusion of 0.9% normal saline (NS). We now hypothesize reducing resuscitation infusion speed through a stepwise infusion speed increment protocol using either FFP or NS would provide neuroprotection compared with a high speed resuscitation protocol.Methods23 Yorkshire swine underwent a protocol of computer controlled TBI and 40% hemorrhage. Animals were left in shock (mean arterial pressure of 35 mmHg) for two hours prior to resuscitation with bolus FFP (n = 5, 50 ml/min) or stepwise infusion speed increment FFP (n = 6), bolus NS (n = 5, 165 ml/min) or stepwise infusion speed increment NS (n = 7). Hemodynamic variables over a 6-hour observation phase were recorded. Following euthanasia, brains were harvested and lesion size as well as brain swelling was measured.ResultsBolus FFP resuscitation resulted in greater brain swelling (22.36 ± 1.03% vs. 15.58 ± 2.52%, p = 0.04), but similar lesion size compared with stepwise resuscitation. This was associated with a lower cardiac output (CO: 4.81 ± 1.50 l/min vs. 5.45 ± 1.14 l/min, p = 0.03). In the NS groups, bolus infusion resulted in both increased brain swelling (37.24 ± 1.63% vs. 26.74 ± 1.33%, p = 0.05) as well as lesion size (3285.44 ± 130.81 mm3 vs. 2509.41 ± 297.44 mm3, p = 0.04). This was also associated with decreased cardiac output (NS: 4.37 ± 0.12 l/min vs. 6.35 ± 0.10 l/min, p < 0.01).ConclusionsIn this clinically relevant model of combined TBI and HS, stepwise resuscitation protected the brain compared with bolus resuscitation.

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Effects of anesthesia on fluid volume kinetics after infusion of colloid solution during blood donation

Cited by 4 publications

References 23 publications

Population-based volume kinetics of crystalloids and colloids in healthy volunteers

Population-based volume kinetics of crystalloids and colloids in healthy volunteers

Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy

Resuscitation speed affects brain injury in a large animal model of traumatic brain injury and shock

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