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Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution
BACKGROUND: Plasma expanders are widely used for acute normovolemic hemodilution (ANH). However, existing studies have not focused on large-volume infusion with colloidal plasma expanders, and there is a lack of studies that compare the effects of different plasma expanders. METHODS: The viscosity,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656672/ https://www.ncbi.nlm.nih.gov/pubmed/33172500 http://dx.doi.org/10.1186/s40779-020-00282-4 |
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author | You, Guo-Xing Li, Bing-Ting Wang, Zhen Wang, Quan Wang, Ying Zhao, Jing-Xiang Zhao, Lian Zhou, Hong |
author_facet | You, Guo-Xing Li, Bing-Ting Wang, Zhen Wang, Quan Wang, Ying Zhao, Jing-Xiang Zhao, Lian Zhou, Hong |
author_sort | You, Guo-Xing |
collection | PubMed |
description | BACKGROUND: Plasma expanders are widely used for acute normovolemic hemodilution (ANH). However, existing studies have not focused on large-volume infusion with colloidal plasma expanders, and there is a lack of studies that compare the effects of different plasma expanders. METHODS: The viscosity, hydrodynamic radius (R(h)) and colloid osmotic pressure (COP) of plasma expanders were determined by a cone-plate viscometer, Zetasizer and cut-off membrane, respectively. Sixty male rats were randomized into five groups with Gelofusine (Gel), Hydroxyethyl Starch 200/0.5 (HES200), Hydroxyethyl Starch 130/0.4 (HES130), Hydroxyethyl Starch 40 (HES40), and Dextran40 (Dex40), with 12 rats used in each group to build the ANH model. ANH was performed by the withdrawal of blood and simultaneous infusion of plasma expanders. Acid-base, lactate, blood gas and physiological parameters were detected. RESULTS: Gel had a lower intrinsic viscosity than HES200 and HES130 (P < 0.01), but at a low shear rate in a mixture of colloids, red cells and plasma, Gel had a higher viscosity (P < 0.05 or P < 0.01, respectively). For hydroxyethyl starch plasma expanders, the COP at a certain concentration decreases from 11.1 mmHg to 6.1 mmHg with the increase of R(h) from 10.7 nm to 20.2 nm. A severe ANH model, with the hematocrit of 40% of the baseline level, was established and accompanied by disturbances in acid-base, lactate and blood gas parameters. At the end of ANH and 60 min afterward, the Dex40 group showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other groups. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) decreased significantly in all groups at the end of ANH. The DBP and MAP in the Dex40 group further decreased 60 min after the end of ANH. During the process of ANH, the Dex40 group showed a drop and recovery in SBP, DBP and MAP. The DBP and MAP in the HES200 group were significantly higher than those in the other groups at some time points (P < 0.05 or P < 0.01). CONCLUSION: Gel had a low intrinsic viscosity but may increase the whole blood viscosity at low shear rates. R(h) and COP showed a strong correlation among hydroxyethyl starch plasma expanders. Dex40 showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other plasma expanders. During the process of ANH, Dex40 displayed a V-shaped recovery pattern for blood pressure, and HES200 had the advantage in sustaining the DBP and MAP at some time points. |
format | Online Article Text |
id | pubmed-7656672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-76566722020-11-12 Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution You, Guo-Xing Li, Bing-Ting Wang, Zhen Wang, Quan Wang, Ying Zhao, Jing-Xiang Zhao, Lian Zhou, Hong Mil Med Res Research BACKGROUND: Plasma expanders are widely used for acute normovolemic hemodilution (ANH). However, existing studies have not focused on large-volume infusion with colloidal plasma expanders, and there is a lack of studies that compare the effects of different plasma expanders. METHODS: The viscosity, hydrodynamic radius (R(h)) and colloid osmotic pressure (COP) of plasma expanders were determined by a cone-plate viscometer, Zetasizer and cut-off membrane, respectively. Sixty male rats were randomized into five groups with Gelofusine (Gel), Hydroxyethyl Starch 200/0.5 (HES200), Hydroxyethyl Starch 130/0.4 (HES130), Hydroxyethyl Starch 40 (HES40), and Dextran40 (Dex40), with 12 rats used in each group to build the ANH model. ANH was performed by the withdrawal of blood and simultaneous infusion of plasma expanders. Acid-base, lactate, blood gas and physiological parameters were detected. RESULTS: Gel had a lower intrinsic viscosity than HES200 and HES130 (P < 0.01), but at a low shear rate in a mixture of colloids, red cells and plasma, Gel had a higher viscosity (P < 0.05 or P < 0.01, respectively). For hydroxyethyl starch plasma expanders, the COP at a certain concentration decreases from 11.1 mmHg to 6.1 mmHg with the increase of R(h) from 10.7 nm to 20.2 nm. A severe ANH model, with the hematocrit of 40% of the baseline level, was established and accompanied by disturbances in acid-base, lactate and blood gas parameters. At the end of ANH and 60 min afterward, the Dex40 group showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other groups. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) decreased significantly in all groups at the end of ANH. The DBP and MAP in the Dex40 group further decreased 60 min after the end of ANH. During the process of ANH, the Dex40 group showed a drop and recovery in SBP, DBP and MAP. The DBP and MAP in the HES200 group were significantly higher than those in the other groups at some time points (P < 0.05 or P < 0.01). CONCLUSION: Gel had a low intrinsic viscosity but may increase the whole blood viscosity at low shear rates. R(h) and COP showed a strong correlation among hydroxyethyl starch plasma expanders. Dex40 showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other plasma expanders. During the process of ANH, Dex40 displayed a V-shaped recovery pattern for blood pressure, and HES200 had the advantage in sustaining the DBP and MAP at some time points. BioMed Central 2020-11-11 /pmc/articles/PMC7656672/ /pubmed/33172500 http://dx.doi.org/10.1186/s40779-020-00282-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research You, Guo-Xing Li, Bing-Ting Wang, Zhen Wang, Quan Wang, Ying Zhao, Jing-Xiang Zhao, Lian Zhou, Hong Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
title | Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
title_full | Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
title_fullStr | Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
title_full_unstemmed | Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
title_short | Effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
title_sort | effects of different plasma expanders on rats subjected to severe acute normovolemic hemodilution |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656672/ https://www.ncbi.nlm.nih.gov/pubmed/33172500 http://dx.doi.org/10.1186/s40779-020-00282-4 |
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