Fluid Loading Increases Oxygen Consumption in Septic Patients with Lactic Acidosis

Haupt, Marilyn T.; Gilbert, E. M.; Carlson, Richard W.

doi:10.1097/00132586-198604000-00029

Cited by 42 publications

(63 citation statements)

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“…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. Crystalloids, due to small molecular weight, could pass freely across the capillary membrane, so their plasma expanding effect is transit.…”

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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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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“…Hypovolaemia will decrease cardiac output resulting in reduced systemic oxygen delivery, and trigger generalized vasoconstriction by activation of the baroreceptor reflex through unloading of the high-and low-pressure receptors, which may lead to compromised perfusion in more vulnerable regions such as the gut [4][5][6][7]. Correction of low plasma volume therefore may be essential to maintain adequate organ perfusion and oxygen delivery [8,9].…”

Section: Introductionmentioning

confidence: 99%

Plasma volume expansion of 5% albumin, 4% gelatin, 6% HES 130/0.4, and normal saline under increased microvascular permeability in the rat

2006

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Objective: To compare the colloids 5% albumin, 4% gelatine, and 6% HES 130/0.4 with one another, and with saline, regarding their plasma expanding effects at increased permeability, and to compare the results with those from a previous study at normal permeability.Design: Prospective controlled randomised laboratory study.Setting: University research laboratory.Subjects: 48 adult male Sprague-Dawly rats.Interventions: Permeability was increased by an injection of 0.5 ml dextran 70 using the fact that dextran causes anaphylactic reaction in the rat. Plasma volume was determined ( 125 I albumin tracer technique) after anaesthesia, 1 h after the dextran injection (before infusion for 10-15 min of 20 ml/kg bw of each of the colloids or 80 ml/kg of saline), and 3 h later. Blood pressure, haematocrit, blood gases and electrolytes were measured. CVP was measured in 4 rats. Measurements and results:Plasma volume was 41.1±1.9 ml/kg at baseline (n=9), and 29.1±4.1 ml/kg (n=35) 1 h after the dextran injection (p<0.05). Three hours after infusion of the plasma expander, plasma volume had increased by 17.1±3.4 ml/kg in the albumin group, by 7.9±3.6 ml/kg in the gelatine group, by 7.4±4.4 ml/kg in the HES group, and by 12.2±3.1 ml/kg in the saline group. It was unchanged in a control group given no solution (n=7 for all groups) (Means ± SD). Conclusion:Albumin was a more effective plasma volume expander than gelatine or HES or saline (p<0.05), which were equally effective. All solutions showed a smaller plasma expanding effect than observed in a previous study with normal permeability.3

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“…Our adaptation of the respiratory mass spectrometer to pediatric ventilators has allowed us to extensively study systemic hemodynamics and oxygen transport, and the factors affecting them, before and after cardiac www.intechopen.com Accurate Measurement of Systemic Oxygen Consumption in Ventilated Children with Congenital Heart Disease 303 surgery in children with congenital heart defects (Li, Hoschtitzky et al 2004;Li, Hoskote et al 2005;Li, Schulze-Neick et al 2000;). The importance of oxygen transport is increasingly appreciated in the care of critically ill patients, particularly after CPB (Gilbert, Haupt et al 1986;Haupt, Gilbert et al 1985;Hoffman, Ghanayem et al 2000;Li, Hoschtitzky et al 2004;Li, Hoskote et al 2005;Li, Schulze-Neick et al 2000;Oudemans-van Straaten, Jansen et al 1996;Powers, Mannal et al 1973;Tweddell, Hoffman et al 1999;). The fundamental requirement of ICU management is to match systemic oxygen delivery (DO 2 ) to VO 2 , to sustain cellular metabolism and end-organ function.…”

Section: Clinical Applications Of Respiratory Mass Spectrometry In Thmentioning

confidence: 99%

Accurate Measurement of Systemic Oxygen Consumption in Ventilated Children with Congenital Heart Disease

Li¹

2012

Congenital Heart Disease - Selected Aspects

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Fluid Loading Increases Oxygen Consumption in Septic Patients with Lactic Acidosis

Cited by 42 publications

References 0 publications

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

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

Plasma volume expansion of 5% albumin, 4% gelatin, 6% HES 130/0.4, and normal saline under increased microvascular permeability in the rat

Accurate Measurement of Systemic Oxygen Consumption in Ventilated Children with Congenital Heart Disease

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