The Dynamics of Vascular Volume and Fluid Shifts of Lactated Ringer’s Solution and Hypertonic-Saline-Dextran Solutions Infused in Normovolemic Sheep
Infusions of hyperosmotic-hyperoncotic solutions such as hypertonic saline dextran (HSD) are used in Europe for resuscitation of traumatic shock and perioperative volume support as an adjunct to conventional isotonic crystalloids. Whereas plasma volume expansion of HSD has been measured at single ti...
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description | Infusions of hyperosmotic-hyperoncotic solutions such as hypertonic saline dextran (HSD) are used in Europe for resuscitation of traumatic shock and perioperative volume support as an adjunct to conventional isotonic crystalloids. Whereas plasma volume expansion of HSD has been measured at single time points after the intravascular volume expansion, the detailed time course of fluid shifts during and after infusions have not been reported. We compared the time course of volume expansion during and after 30-min infusions of 4 mL/kg HSD and 25 mL/kg lactated Ringer’s solution (LR) in normovolemic conscious splenectomized sheep. Peak plasma volume (Evans blue and hemoglobin dilution) expansion was similar for HSD (7.8 ± 0.9 mL/kg) and the larger sixfold volume of LR (7.2 ± 0.5 mL/kg). However, 30 min after the 30-min infusion (T60), plasma expansion remained larger after HSD (5.1 ± 0.9 mL/kg) than after LR (1.7 ± 0.6 mL/kg). Both solutions caused an equivalent diuresis. Intravascular volume expansion efficiency (VEE), defined as milliliter plasma expansion/milliliter fluid infused at 0 (T30), 30 (T60), and 60 (T90) min after infusion ended was 1.8, 1.3, and 0.8, respectively for HSD, whereas LR provided a VEE of only 0.27, 0.07, and 0.07. The relative expansion efficiency of HSD versus LR, calculated as the ratio (VEEHSD/VEELR), was 7-fold that of LR at the end of infusion T30, and 20-fold at T60, but decreased to 9-fold by T120. Intravascular volume dynamic studies of different volume expanders in animals and patients may provide anesthesiologists with a new tool for monitoring the effectiveness of fluid therapy. |
doi_str_mv | 10.1097/00000539-200110000-00005 |
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Whereas plasma volume expansion of HSD has been measured at single time points after the intravascular volume expansion, the detailed time course of fluid shifts during and after infusions have not been reported. We compared the time course of volume expansion during and after 30-min infusions of 4 mL/kg HSD and 25 mL/kg lactated Ringer’s solution (LR) in normovolemic conscious splenectomized sheep. Peak plasma volume (Evans blue and hemoglobin dilution) expansion was similar for HSD (7.8 ± 0.9 mL/kg) and the larger sixfold volume of LR (7.2 ± 0.5 mL/kg). However, 30 min after the 30-min infusion (T60), plasma expansion remained larger after HSD (5.1 ± 0.9 mL/kg) than after LR (1.7 ± 0.6 mL/kg). Both solutions caused an equivalent diuresis. Intravascular volume expansion efficiency (VEE), defined as milliliter plasma expansion/milliliter fluid infused at 0 (T30), 30 (T60), and 60 (T90) min after infusion ended was 1.8, 1.3, and 0.8, respectively for HSD, whereas LR provided a VEE of only 0.27, 0.07, and 0.07. The relative expansion efficiency of HSD versus LR, calculated as the ratio (VEEHSD/VEELR), was 7-fold that of LR at the end of infusion T30, and 20-fold at T60, but decreased to 9-fold by T120. Intravascular volume dynamic studies of different volume expanders in animals and patients may provide anesthesiologists with a new tool for monitoring the effectiveness of fluid therapy.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1097/00000539-200110000-00005</identifier><identifier>PMID: 11574341</identifier><identifier>CODEN: AACRAT</identifier><language>eng</language><publisher>Hagerstown, MD: International Anesthesia Research Society</publisher><subject>Algorithms ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Blood Volume - physiology ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Coloring Agents ; Dextrans - pharmacology ; Diuresis - drug effects ; Evans Blue ; Female ; Fluid Shifts - physiology ; Hemodilution ; Hemodynamics - drug effects ; Hemoglobins - metabolism ; Isotonic Solutions - pharmacology ; Medical sciences ; Osmolar Concentration ; Ringer's Solution ; Saline Solution, Hypertonic - pharmacology ; Sheep ; Transfusions. Complications. Transfusion reactions. 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Whereas plasma volume expansion of HSD has been measured at single time points after the intravascular volume expansion, the detailed time course of fluid shifts during and after infusions have not been reported. We compared the time course of volume expansion during and after 30-min infusions of 4 mL/kg HSD and 25 mL/kg lactated Ringer’s solution (LR) in normovolemic conscious splenectomized sheep. Peak plasma volume (Evans blue and hemoglobin dilution) expansion was similar for HSD (7.8 ± 0.9 mL/kg) and the larger sixfold volume of LR (7.2 ± 0.5 mL/kg). However, 30 min after the 30-min infusion (T60), plasma expansion remained larger after HSD (5.1 ± 0.9 mL/kg) than after LR (1.7 ± 0.6 mL/kg). Both solutions caused an equivalent diuresis. Intravascular volume expansion efficiency (VEE), defined as milliliter plasma expansion/milliliter fluid infused at 0 (T30), 30 (T60), and 60 (T90) min after infusion ended was 1.8, 1.3, and 0.8, respectively for HSD, whereas LR provided a VEE of only 0.27, 0.07, and 0.07. The relative expansion efficiency of HSD versus LR, calculated as the ratio (VEEHSD/VEELR), was 7-fold that of LR at the end of infusion T30, and 20-fold at T60, but decreased to 9-fold by T120. Intravascular volume dynamic studies of different volume expanders in animals and patients may provide anesthesiologists with a new tool for monitoring the effectiveness of fluid therapy.</description><subject>Algorithms</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Volume - physiology</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>Coloring Agents</subject><subject>Dextrans - pharmacology</subject><subject>Diuresis - drug effects</subject><subject>Evans Blue</subject><subject>Female</subject><subject>Fluid Shifts - physiology</subject><subject>Hemodilution</subject><subject>Hemodynamics - drug effects</subject><subject>Hemoglobins - metabolism</subject><subject>Isotonic Solutions - pharmacology</subject><subject>Medical sciences</subject><subject>Osmolar Concentration</subject><subject>Ringer's Solution</subject><subject>Saline Solution, Hypertonic - pharmacology</subject><subject>Sheep</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Urodynamics - physiology</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1ksuOFCEUhonROG3rKxg2ukOhCqhiaebiTNLRxO7MltDUKRuloIUqx975FCa-nk8ifXFmJZuT8-c7l5wfhDCjbxhVzVu6f6JWpKKUsX1CDsojNGOikqQRqn2MZkWqSaWUOkPPcv5SUkZb-RSdMSYaXnM2Q79WG8AXu2AGZzOOPb412U7eJHwb_TQANqHDV35yHV5uXD8emIWxoxmhw59c-Azpz8_fGS8LProYDgXXuy2kMQZnydJ4F4BcwI8xmXCPZXwT-imXHi7gDzEN8Xv0UJYoYwC2z9GT3vgML05xjlZXl6vza7L4-P7m_N2CWF5LQcACMC6FhVbWa94xtZY9AO2Ay7bj1NqGUcE4sEbUDVAljFC96UxFhZS0nqPXx7bbFL9NkEc9uGzBexMgTlk3rKJ1q0QB2yNoU8w5Qa-3yQ0m7TSjem-J_meJvrdEH5U5enmaMa0H6B4KTx4U4NUJKKc3vi9nsi4_cJyWVat9I37k7qIfIeWvfrqDpDdg_LjR__sS9V9c_6Xb</recordid><startdate>20011001</startdate><enddate>20011001</enddate><creator>Tølløfsrud, Stein</creator><creator>Elgjo, Geir I.</creator><creator>Prough, Donald S.</creator><creator>Williams, Chad A.</creator><creator>Traber, Daniel L.</creator><creator>Kramer, George C.</creator><general>International Anesthesia Research Society</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20011001</creationdate><title>The Dynamics of Vascular Volume and Fluid Shifts of Lactated Ringer’s Solution and Hypertonic-Saline-Dextran Solutions Infused in Normovolemic Sheep</title><author>Tølløfsrud, Stein ; Elgjo, Geir I. ; Prough, Donald S. ; Williams, Chad A. ; Traber, Daniel L. ; Kramer, George C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4365-ecee1465ce863b4d19b6fee0de468d40cc710514e17537e095a59fada2056603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Algorithms</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Blood Volume - physiology</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>Coloring Agents</topic><topic>Dextrans - pharmacology</topic><topic>Diuresis - drug effects</topic><topic>Evans Blue</topic><topic>Female</topic><topic>Fluid Shifts - physiology</topic><topic>Hemodilution</topic><topic>Hemodynamics - drug effects</topic><topic>Hemoglobins - metabolism</topic><topic>Isotonic Solutions - pharmacology</topic><topic>Medical sciences</topic><topic>Osmolar Concentration</topic><topic>Ringer's Solution</topic><topic>Saline Solution, Hypertonic - pharmacology</topic><topic>Sheep</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Urodynamics - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tølløfsrud, Stein</creatorcontrib><creatorcontrib>Elgjo, Geir I.</creatorcontrib><creatorcontrib>Prough, Donald S.</creatorcontrib><creatorcontrib>Williams, Chad A.</creatorcontrib><creatorcontrib>Traber, Daniel L.</creatorcontrib><creatorcontrib>Kramer, George C.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tølløfsrud, Stein</au><au>Elgjo, Geir I.</au><au>Prough, Donald S.</au><au>Williams, Chad A.</au><au>Traber, Daniel L.</au><au>Kramer, George C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Dynamics of Vascular Volume and Fluid Shifts of Lactated Ringer’s Solution and Hypertonic-Saline-Dextran Solutions Infused in Normovolemic Sheep</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>2001-10-01</date><risdate>2001</risdate><volume>93</volume><issue>4</issue><spage>823</spage><epage>831</epage><pages>823-831</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><coden>AACRAT</coden><abstract>Infusions of hyperosmotic-hyperoncotic solutions such as hypertonic saline dextran (HSD) are used in Europe for resuscitation of traumatic shock and perioperative volume support as an adjunct to conventional isotonic crystalloids. Whereas plasma volume expansion of HSD has been measured at single time points after the intravascular volume expansion, the detailed time course of fluid shifts during and after infusions have not been reported. We compared the time course of volume expansion during and after 30-min infusions of 4 mL/kg HSD and 25 mL/kg lactated Ringer’s solution (LR) in normovolemic conscious splenectomized sheep. Peak plasma volume (Evans blue and hemoglobin dilution) expansion was similar for HSD (7.8 ± 0.9 mL/kg) and the larger sixfold volume of LR (7.2 ± 0.5 mL/kg). However, 30 min after the 30-min infusion (T60), plasma expansion remained larger after HSD (5.1 ± 0.9 mL/kg) than after LR (1.7 ± 0.6 mL/kg). Both solutions caused an equivalent diuresis. Intravascular volume expansion efficiency (VEE), defined as milliliter plasma expansion/milliliter fluid infused at 0 (T30), 30 (T60), and 60 (T90) min after infusion ended was 1.8, 1.3, and 0.8, respectively for HSD, whereas LR provided a VEE of only 0.27, 0.07, and 0.07. The relative expansion efficiency of HSD versus LR, calculated as the ratio (VEEHSD/VEELR), was 7-fold that of LR at the end of infusion T30, and 20-fold at T60, but decreased to 9-fold by T120. Intravascular volume dynamic studies of different volume expanders in animals and patients may provide anesthesiologists with a new tool for monitoring the effectiveness of fluid therapy.</abstract><cop>Hagerstown, MD</cop><pub>International Anesthesia Research Society</pub><pmid>11574341</pmid><doi>10.1097/00000539-200110000-00005</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Algorithms Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Blood Volume - physiology Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Coloring Agents Dextrans - pharmacology Diuresis - drug effects Evans Blue Female Fluid Shifts - physiology Hemodilution Hemodynamics - drug effects Hemoglobins - metabolism Isotonic Solutions - pharmacology Medical sciences Osmolar Concentration Ringer's Solution Saline Solution, Hypertonic - pharmacology Sheep Transfusions. Complications. Transfusion reactions. Cell and gene therapy Urodynamics - physiology |
title | The Dynamics of Vascular Volume and Fluid Shifts of Lactated Ringer’s Solution and Hypertonic-Saline-Dextran Solutions Infused in Normovolemic Sheep |
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