Limiting edema in neonatal cardiopulmonary bypass with narrow-range molecular weight hydroxyethyl starch

Yeh, Thomas; Jm, Parmar; Im, Rebeyka; Gk, Lofland; El, Allen; Rj, Dignan; Cm, Dyke; As, Wechsler

doi:10.1016/s0022-5223(19)34733-6

Cited by 43 publications

(12 citation statements)

References 16 publications

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“…In experimental ischemia-reperfusion models, HES compared to crystalloids have been shown to reduce capillary leak and tissue edema. 20,21 In septic shock patients and patients with acute lung injury, the influence of two colloids (gelatin vs. 6% HES 200/0.62) on extravascular lung water (EVLW) was compared. 22 Both colloids showed similar effects on hemodynamics associated with no increase in EVLW and without negative effects on oxygenation.…”

Section: Capillary Leak and Edema Formationmentioning

confidence: 99%

Crystalloids versus colloids: the end of an old debate?

Boldt

2010

Transfusion Alternatives in Transfusion Medicine

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SUMMARY The ‘ideal’ plasma substitute for volume replacement remains a matter of dispute. Merits and demerits of colloids versus crystalloids for volume replacement have been discussed very emotionally. Are we any wiser concerning the crystalloid/colloid problem? Recently published meta‐analyses or evidence‐based medicine analyses appear to be less helpful to solve this problem. Conflicting results from different studies are most likely as a result of variations in clinical protocols, selection of patients, criteria for blood or volume administration. With their conflicting results more questions arise than answers are given.

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Section: Capillary Leak and Edema Formationmentioning

confidence: 99%

Crystalloids versus colloids: the end of an old debate?

Boldt

2010

Transfusion Alternatives in Transfusion Medicine

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“…It could prove to be an important additive to the prime. 2 The use of gelatins as pump priming agents is currently under investigation. 69 These are processed by the degradation of collagen and the cleavage of molecular polypeptide chains, crosslinking them with different chemical substance such as glyoxal, succinic acid, or isocyanide.…”

Section: Primementioning

confidence: 99%

Neonatal cardiopulmonary bypass—a review of current practice in North America

et al. 1993

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One of the most challenging applications of cardiopulmonary bypass is corrective cardiac surgery in the neonate. The small size and high metabolic demand of these patients require miniaturized but efficient equipment. Even with the most advanced components, the volume required to prime the perfusion circuit is typically more than twice the blood volume of a neonate. Neonates have limited cardiac and pulmonary reserves and, therefore, great care is required to preserve those organs that have often already been subjected to hypoxemia, congestive heart failure, or low cardiac output prior to surgery. There is a tendency toward extravascular movement of fluids in newborns subjected to bypass that can adversely affect outcome. Careful monitoring and precise management of perfusion are essential to a successful procedure and optimal recovery of these patients.

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“…Although maintenance of intravascular volume for this clinical problem is of paramount importance, the relative immunomodulatory effect of HES is a topic of speculation and active investigation. Several studies have shown beneficial effects of HES on organ damage in the treatment of severe inflammatory situations (6, 7). For example, in a model of edema formation in neonatal cardiopulmonary bypass, HES treatment was found to significantly lower percent tissue water of kidney, pancreas, stomach, jejunum, colon, and skeletal muscle (6).…”

mentioning

confidence: 99%

“…Several studies have shown beneficial effects of HES on organ damage in the treatment of severe inflammatory situations (6, 7). For example, in a model of edema formation in neonatal cardiopulmonary bypass, HES treatment was found to significantly lower percent tissue water of kidney, pancreas, stomach, jejunum, colon, and skeletal muscle (6). In accordance is the finding of a significantly greater patent sinusoidal lumen and higher patent capillary proportion of lung tissue in a septic porcine model treated with median molecular weight HES than treated with other colloids (7).…”

mentioning

confidence: 99%