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

Abstract

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

Comparative Study Between Succinylated Gelatin (Gelofusine) Versus Ringer’s Acetate Regarding Safety and Efficacy in Adult Patients Undergoing Cardiac Surgery.

“…This is met with several studies which denoted that colloids are more effective regarding their plasma expanding property than crystalloids. (9,21) Regarding 4% succinylated gelatin (the colloid of use in this study), and being a colloid of low average molecular weight, there was a believe that it escapes the capillary pores faster than that of medium and high molecular weight can do, hence, less plasma expanding effect (23) , however several studies have described gelatins and starches as equal plasma expanders both in: animal models (24)(25)(26) and human. (20,27) Moreover, in their study, Dileep et al (21) have described an equal duration of plasma expansion of both 4% succinylated gelatin (gelofusine) and 6% hydroxyethyl starch (Voluven) attributing this to the fact that hydroxyethyl starch is eliminated by the cleavage action of the serum amylase, which increased four times after infusion of hydroxyethyl starch as reported by Wilkes et al (28) The PaCO2 levels in this study were maintained by ventilation therefore, base excess (BE) and PH changes reflected any change in the non-respiratory (i.e.…”

Isolated Brain Trauma in Cats Triggers Rapid Onset of Hypovolemia

“…To calculate the amount of radioactivity given, the remaining radioactivity in the emptied vial, syringe, and needle used was measured and subtracted from the total radioactivity in the prepared dose. This is a reliable and established technique for PV measurement with small sources of error and reproducible results [20, 21, 23] (see “Discussion” section). Free iodine following precipitation with 10% trichloroacetic acid was measured regularly and was found to be less than 1.6% in all experiments.…”

The viscous behaviour of HES 130/0.4 (Voluven®) and HES 260/0.45 (Pentaspan®)

“…l: viscosity R: radius of tube DP: pressure drop Q: flow L: length between pressure taps Shear rates for laminar flow were calculated using equation (2), which allowed for the derivation of shear stress using the calculated viscosities from the above equation (3). The reported viscosity and shear stress values for HES and matching glycerol-water mixtures represented the average of four independent pipe flow measurements.…”

“…1 During periods of low blood volume, the body attempts to compensate for this reduction through a redistribution of flow that may compromise perfusion rates to non-vital organs and the microvasculature. 2,3 Effective management of blood volume replacement is thus paramount to ensure adequate peripheral tissue perfusion and oxygenation. 2,4 Although the merits of effective volume replacement have been well established, there continues to be on-going debate regarding the ideal fluid for volume therapy.…”