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Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers

BACKGROUND: “Interstitial washdown” is an edema-preventing mechanism that implies a greater redistribution of interstitial albumin occurs whenever the capillary filtration is increased. OBJECTIVE: To study the effect of interstitial washdown on fluid distribution in normovolemic and hypovolemic volu...

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Autor principal: Hahn, Robert G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986696/
https://www.ncbi.nlm.nih.gov/pubmed/36336925
http://dx.doi.org/10.3233/CH-221531
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author Hahn, Robert G.
author_facet Hahn, Robert G.
author_sort Hahn, Robert G.
collection PubMed
description BACKGROUND: “Interstitial washdown” is an edema-preventing mechanism that implies a greater redistribution of interstitial albumin occurs whenever the capillary filtration is increased. OBJECTIVE: To study the effect of interstitial washdown on fluid distribution in normovolemic and hypovolemic volunteers. METHODS: Capillary filtration was increased by infusing 25 mL/kg Ringer’s acetate intravenously over 30 min 10 male just after withdrawal of 0, 450, and 900 mL of blood. Population volume kinetic analysis was used to assess the effects of washdown and hemorrhage on fluid distribution, using the difference in plasma dilution based on hemoglobin and albumin as biomarker of washdown. RESULTS: Blood withdrawal during 10–15 min recruited 100–150 mL of fluid of high albumin content to the plasma, which was probably lymph. The albumin recruitment was temporarily reduced during the fluid loading but increased from 40 min post-infusion and was then greater when preceded by hemorrhage. Simulations suggested that interstitial washdown decreased the extravascular fluid volume by 200 mL over 3 h. The plasma volume and urinary excretion both increased by approximately half this amount. CONCLUSIONS: Blood loss without hypotension probably recruited lymph to the plasma, but interstitial washdown played no major role in determining the distribution of crystalloid fluid after hemorrhage.
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spelling pubmed-99866962023-03-07 Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers Hahn, Robert G. Clin Hemorheol Microcirc Research Article BACKGROUND: “Interstitial washdown” is an edema-preventing mechanism that implies a greater redistribution of interstitial albumin occurs whenever the capillary filtration is increased. OBJECTIVE: To study the effect of interstitial washdown on fluid distribution in normovolemic and hypovolemic volunteers. METHODS: Capillary filtration was increased by infusing 25 mL/kg Ringer’s acetate intravenously over 30 min 10 male just after withdrawal of 0, 450, and 900 mL of blood. Population volume kinetic analysis was used to assess the effects of washdown and hemorrhage on fluid distribution, using the difference in plasma dilution based on hemoglobin and albumin as biomarker of washdown. RESULTS: Blood withdrawal during 10–15 min recruited 100–150 mL of fluid of high albumin content to the plasma, which was probably lymph. The albumin recruitment was temporarily reduced during the fluid loading but increased from 40 min post-infusion and was then greater when preceded by hemorrhage. Simulations suggested that interstitial washdown decreased the extravascular fluid volume by 200 mL over 3 h. The plasma volume and urinary excretion both increased by approximately half this amount. CONCLUSIONS: Blood loss without hypotension probably recruited lymph to the plasma, but interstitial washdown played no major role in determining the distribution of crystalloid fluid after hemorrhage. IOS Press 2023-02-28 /pmc/articles/PMC9986696/ /pubmed/36336925 http://dx.doi.org/10.3233/CH-221531 Text en © 2023 – The authors. Published by IOS Press https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hahn, Robert G.
Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers
title Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers
title_full Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers
title_fullStr Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers
title_full_unstemmed Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers
title_short Interstitial washdown during crystalloid fluid loading in graded hypovolemia –A retrospective analysis in volunteers
title_sort interstitial washdown during crystalloid fluid loading in graded hypovolemia –a retrospective analysis in volunteers
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986696/
https://www.ncbi.nlm.nih.gov/pubmed/36336925
http://dx.doi.org/10.3233/CH-221531
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