Safety of Plasma Volume Expanders

Farrugia, Albert

doi:10.1177/0091270010372107

Cited by 15 publications

(9 citation statements)

References 87 publications

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“…The enzymatic hydrolysis study was used to determine the resistance of fractionated amylopectin and the modified starch to enzyme. [1216171819202122252627] For the desired optimum activity of the PVE to use, the rate of elimination of the PVEs must be slow. The enzyme amylase present in the blood causes the degradation of amylopectin into smaller fragments.…”

Section: Methodsmentioning

confidence: 99%

“…[8] In addition, the major risk of the transfusion of the blood is the transmission of the diseases such as hepatitis and HIV infection to the recipients. [79101112] Thus, in the case of the acute blood loss, the plasma substitute is preferred over the whole blood as the risk of transmission of these deadly diseases is avoided. [29] For the past two decades, the much of the research work is done in the field of the plasma substitute, and the various effects of these plasma volume expanders (PVEs) on the physiology were studied.…”

Section: Introductionmentioning

confidence: 99%

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Formulation and development of plasma volume expander using natural and modified starch from Solanum tuberosum

Thombre¹,

Vishwakarma²,

Jadhav³

et al. 2016

Int J Pharma Investig

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Background:To formulation and development of plasma volume expander (PVE) by using natural and modified starch from Solanum tuberosum. The function of blood circulation is to provide the needs of the body tissues and to maintain an appropriate environment in all tissue fluids of the body for the optimal survival and functions of the cells. Rapid restoration of the blood volume is necessary to decrease reduction in the amount of the blood. The PVEs are isotonic colloidal solutions, act by increasing the osmotic pressure of the intravascular compartment, which leads to the influx of the interstitial fluids through the capillary pore which, in turn, leads to the increase in the volume of the blood. Therefore, there is a need to discover the PVE with less side effects. The main aim of the present study is to use amylopectin as PVEs, fractionated from natural and modified starch obtained from S. tuberosum.Methods:The starch extracted from the normal grains and the tubers of potatoes was selected for the production of starch. Statistical analysis includes in vitro characterization that involves viscosity studies, plasma–product interaction, osmotic pressure detection, molecular weight–viscosity relationship, determination of weight average molecular weight, enzymatic interaction, and in vivo characterization such as toxicity studies and the effect of the products on the blood coagulation. The isolated starch and fractionated amylopectin were analyzed for the physicochemical characteristics.Result and Conclusion:The amylopectin fractionated from isolated starch from grains and tubers of potatoes can be used as PVE, as per the outcome of the study.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Formulation and development of plasma volume expander using natural and modified starch from Solanum tuberosum

Thombre¹,

Vishwakarma²,

Jadhav³

et al. 2016

Int J Pharma Investig

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show abstract

“…The analysis was conducted in OpenBUGS version 3.2.1; see code for details (Program 1 (a) in [37]. Other adverse events associated with colloids including hypotension, bleeding and pruritus [39] were considered for inclusion in the analysis but were not fully reported or were associated with low incidence (<1%) in the trials chosen. Hence, analysis was limited to the widely reported issue of renal dysfunction as assessed through the need for renal replacement therapy.…”

Section: Methodsmentioning

confidence: 99%

Relative Survival Benefit and Morbidity with Fluids in Severe Sepsis - A Network Meta-Analysis of Alternative Therapies

Bansal

Farrugia²,

Balboni³

et al. 2013

CDS

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Background: Fluid resuscitation is widely practiced in intensive care units for the treatment of sepsis. A comparison of the evidence base of different fluids may inform therapeutic choice. Methods: The risks of mortality and morbidity (the need for renal replacement therapies (RRT)) were assessed in patients with severe sepsis. A network meta-analysis compared trials for crystalloids, albumin and hydroxyethyl starch (HES). A literature search of human randomized clinical trials was conducted in databases, the bibliographies of other recent relevant systematic reviews and data reported at recent conferences. Mortality outcomes and RRT data with the longest follow up period were compared. A Bayesian network meta-analysis assessed the risk of mortality and a pair-wise meta-analysis assessed RRT using crystalloids as the reference treatment. Results: 13 studies were identified. A fixed-effects meta-analysis of mortality data in the trials demonstrated an odds-ratio (OR) of 0.90 between crystalloids and albumin, 1.25 between crystalloids and HES and 1.40 between albumin and HES. The probability that albumin is associated with the highest survival was 96.4% followed by crystalloid at 3.6%, with a negligible probability for HES. Sub-group analyses demonstrated the robustness of this result to variations in fluid composition, study source and origin of septic shock. A random-effects pairwise comparison for the risk of RRT provided an OR of 1.52 favoring crystalloid over HES. Conclusion: Fluid therapy with albumin was associated with the highest survival benefit. The higher morbidity with HES may affect mortality and requires consideration by prescribers.

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“…Dextrans and hydroxyethyl starches (HESs) are synthetic colloids of macromolecular size generally used in the clinical setting as plasma volume expanders to restore blood volume deficit after surgical hemorrhages or trauma. [1][2][3][4] In addition to the postoperative practice, the capability of plasma volume expanders to remain confined in the vascular compartment has been widely exploited for several preclinical applications, mainly to improve vascular perfusion and assess the vascular integrity/permeability of angiogenic vessels. [5][6][7] In oncology, monitoring the extravasation of dextran molecules with increasing molecular weight indicated the ideal cutoff for optimal tissue penetration and accumulation, with significant improvement for therapeutic treatments.…”

Section: Introductionmentioning

confidence: 99%

Investigating plasma volume expanders as novel macromolecular MRI‐CEST contrast agents for tumor contrast‐enhanced imaging

Consolino

Irrera

Romdhane

et al. 2021

Magnetic Resonance in Med

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The aim of this study was to investigate two clinically approved plasma volume expanders (dextran 70 and voluven) as macromolecular MRI-chemical exchange saturation transfer (CEST) contrast agents to assess tumor vascular properties. Methods: CEST contrast efficiency of both molecules (6% w/v) was measured in vitro at various irradiation saturation powers (1-6 μT for 5 s) and pH values (range, 5.5-7.9) and the exchange rate of hydroxyl protons was calculated. In vivo studies in a murine adenocarcinoma model (n = 4 mice for each contrast agent) upon i.v. injection provided CEST-derived perfusion tumor properties that were compared with those obtained with a gadolinium-based blood-pool agent (Gd-AAZTA-Madec). Results: In vitro measurements showed a marked CEST contrast dependency to pH, with higher CEST contrast at lower pH values for both molecules. The measured prototropic exchange rates confirmed a base-catalyzed exchange rate that was faster for dextran 70 in comparison to voluven. Both molecules showed a similar CEST contrast increase (ΔST% > 3%) in the tumor tissue up to 30 min postinjection, with heterogeneous accumulation. In tumors receiving both CEST and T 1 -weighted agents, a voxel-by-voxel analysis indicated moderate spatial correlation of perfusion properties between voluven/dextran 70 and Gd-AAZTA-Madec, suggesting different distribution patterns according to their molecular size. Conclusions: The obtained results showed that both voluven and dextran 70 can be exploited as MRI-CEST contrast agents for evaluating tumor enhancement properties. Their increased accumulation in tumors and prolonged contrast enhancement promote their use as blood-pool MRI-CEST agents to examine tumor vascularization.

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Safety of Plasma Volume Expanders

Cited by 15 publications

References 87 publications

Formulation and development of plasma volume expander using natural and modified starch from Solanum tuberosum

Formulation and development of plasma volume expander using natural and modified starch from Solanum tuberosum

Relative Survival Benefit and Morbidity with Fluids in Severe Sepsis - A Network Meta-Analysis of Alternative Therapies

Investigating plasma volume expanders as novel macromolecular MRI‐CEST contrast agents for tumor contrast‐enhanced imaging

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