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At least 235 records · Page 13Linked to original sources
PubMed1999

[The effects of moderate acute normovolemic hemodilution on intestinal oxygen supply and consumption in anesthetized cats].

OBJECTIVE: To study the effects of moderate acute normovolemic hemodilution on the intestinal blood perfusion and oxygen supply in cats. METHODS: 15 domestic male cats were hemodiluted with Haemaccel. HR, MAP, lactate concentration in superior mesenteric vein (LAC), superior mesenteric artery blood flow (SMABF), superior mesenteric artery and venous blood gas analysis were recorded and the intestinal oxygen delivery (DO(2)), oxygen consumption (VO(2)) and oxygen extraction (EO(2)) were calculated before and after hemodilution. RESULTS: SMABF increased obviously (P < 0.05), intestinal DO(2) and EO(2) did not change (P > 0.05) but VO(2) increased (P < 0.05), and LAC in superior mesenteric vein did not increase. CONCLUSIONS: Moderate acute normovolemic hemodilution with Haemaccel do not alter intestinal oxygen delivery by increasing the superior mesenteric blood flow. It means that intestinal mucosa ischemia does not happen during moderate acute normovolemic hemodilution.

Animals↗
PubMed2003

[Acute normovolaemic haemodilution in children].

Acute normovolemic haemodilution was performed in 34 children (4-6 years old, weight: 16-68 kg) in whom major blood loss was expected during operation. Anaesthesia was induced with thiopentone, and then maintained with N2O/O2, fentanyl and pipecuronium. IPPV was used to maintain normocapnia. Heart rate, blood pressure, central venous pressure and core body temperature were monitored during haemodilution and throughout the surgery. A predetermined volume of blood to reduce hematocrit value to 30% was withdrawn in standard collection bags. In one child from Jehovah's Witness family hematocrit following haemodilution was only 20%. Every 1 ml of withdrawn blood was replaced with 1 ml of Haemaccel (Boehring, 32 children) or with 3 ml of isotonic crystalloid solution (PWE Polfa, 2 children). The blood lost during surgery was replaced with crystalloid solution and Haemaccel. Normovolemic loss of blood to haematocrit value of 20-24% was permitted. Retransfusion of collected blood was started when major bleeding was over, or when hematocrit decreased below 20-24%. Only 8 children needed homologous blood transfusion. Heart rate decreased significantly during haemodilution, while blood pressure remained stable. Low initial haematocrit and coagulopathy due to dilution of the plasma clotting factors were the limiting factors of the method. Partial thromboplastin time and plasma fibrinogen should be monitored throughout surgery, because the occurrence of coagulopathy promptly allows to initiate retransfusion of autologous blood.

Adolescent↗
PubMed1992

Acute and chronic regulation of atrial natriuretic peptide in human pregnancy: a longitudinal study.

OBJECTIVE: To determine whether the increase in extracellular fluid volume (ECFV) that occurs during pregnancy alters: (1) the baseline regulation of atrial natriuretic peptide (ANP); or (2) the ANP response to intravascular volume expansion with either haemaccel or hypertonic saline. DESIGN: A group of normal pregnant subjects was studied longitudinally on three occasions, commencing before 16 weeks of gestation. They were compared with a group of age-matched non-pregnant women. Dietary sodium intake and posture were carefully controlled. METHODS: Plasma volume and total ECFV were determined by tracer dilution methods, using Evans Blue and 20% mannitol, respectively. Plasma ANP and aldosterone concentrations were measured by radioimmunoassay. RESULTS: Plasma ANP did not increase during pregnancy despite increases in both plasma and total ECFV. The plasma ANP response to acute intravenous volume expansion in later pregnancy appears to be more sensitive than either in early pregnancy or in non-pregnant subjects. The initial ANP response to infusions of haemaccel during pregnancy was greater than the ANP response to saline. CONCLUSIONS: During a normal pregnancy, plasma ANP is maintained in the normal non-pregnant range, despite an increase in plasma volume when the effects of dietary sodium intake and posture are carefully accounted for. The ANP response to intravenous volume expansion is enhanced in late pregnancy. The greater ANP response to haemaccel infusions during pregnancy suggests that an increase in atrial stretch mediates the secretion of ANP following intravenous volume expansion.

Adult↗
PubMed2005

Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock.

OBJECTIVE: To compare the efficacy of crystalloid (Normal saline) and colloid (polymer from degraded Gelatin in saline Haemaccel) intravenous fluid in restoration of circulating volume in children with septic shock. DESIGN: Prospective, randomized, open-label trial. SETTING: Pediatric Emergency and Intensive Care Unit of a tertiary care referral and teaching hospital. SUBJECTS AND INCLUSION CRITERIA: Sixty patients, between 1 month to 12 years of age, with septic shock, without clinical evidence of organ failure at admission or underlying immunodeficiency. INTERVENTION: Resuscitation with normal saline or polymer from degraded gelatin (Haemaccel) in the boluses rate of 20 mL/kg till hemodynamic stabilization or if central venous pressure (CVP) exceeded 10 mmHg (fluid requirement beyond 40 mL/kg guided by BP and CVP). METHODS: Hemodynamic parameters (heart rate, capillary filling time, pulse volume, and blood pressure) were recorded before and during resuscitation, and then 2 hourly for 12 hours. Central venous pressure line was placed within first hour, soon after starting fluids. Estimation of plasma volume and body water was done at the end of first hour of fluid resuscitation. OUTCOME MEASURES: Hemodynamic stabilization (heart rate, capillary refill time, systolic BP in normal range), plasma volume at the end of fluid resuscitation and incidence of organ dysfunction. RESULTS: 31 patients were randomized to normal saline and 29 to gelatin polymer. Both the groups were similar with respect to age, gender, primary diagnosis, initial hemodynamic parameters and PRISM score. Pneumonia (n = 22; 36%), gut-associated sepsis (n = 13), and dengue hemorrhagic fever (n = 11) were the common primary diagnosis. Initial hemodynamic stabilization was achieved in all. The mean (SD plasma volume (saline--53.4 (2.0 mL/kg, gelatin polymer--53.2 (1.9 mL/kg), extracellular fluid volume, total body water and interstitial fluid volume at the end of first hour of resuscitation were similar. The requirement of inotropes, incidence of organ dysfunction and case fatality rate (Saline--29%, gelatin polymer--31%), were similar in two groups. CONCLUSION: Both normal saline and gelatin polymer solution were equally effective as resuscitation fluid with respect to restoration of plasma volume and hemodynamic stability. Normal saline upto 110 mL/kg, and gelatin polymer solution upto 70 mL/kg may be required in first hour for successful fluid resuscitation of septic shock in children.

Child↗
PubMed2005

Does preloading with colloids prevent hemodynamic changes when neurosurgical patients are subsequently changed to the seated position?

OBJECTIVE: This prospective, randomized, double-blind study was designed to determine and compare the usefulness of preloading colloids (Haemaccel) 10 ml/Kg before positioning whether it can prevent hemodynamic changes during seated positioning or not. MATERIAL AND METHOD: The authors studied 20 patients by randomly dividing them into 2 groups. The control group was given crystalloid as maintenance and deposit replacement but the study group was given extra colloids 10 ml/Kg 30 minutes before starting general anesthesia. Both groups were monitored and given anesthesia, balanced technique. Systolic and diastolic blood pressures, heart rate, central venous pressure (CVP) at different time intervals in the sitting position for 30 minutes were recorded. Statistical analysis was done by Student t-test, Chi-square test and ANOVA (p-value < 0. 05 considered significant). RESULTS: The results showed that systolic blood pressure at 15, 20, 30 minutes and CVP at 15, 25, 30 minutes after positioning in the study group was maintained significantly compared to the control group and there were no significant changes in diastolic blood pressure and heart rate. There were no other complications during the sitting period. CONCLUSION: It is concluded that preloading colloid fluid prior to repositioning could prevent the decrease of systolic blood pressure and central venous pressure during sitting positioning without other complications.

Adult↗
PubMedDate not supplied

[Clinical and laboratory evaluation of 20% albumin (plasbumin) used in cardiosurgical patients].

A randomized comparative study of the effect of 20% Albumin (Plasbumin) solution and 4% succinylated gelatin (helofusin) solution on homeostasis was conducted in 36 cardiosurgical patients when the solutions were used as components to fill a pump oxygenator (PO). A comparative analysis has indicated that the use of albumin in the primary volume of PO at a concentration of 2-3% provides a higher level of total protein and better maintains colloid osmotic pressure during extracorporeal circulation than that of helofusin. At the end of an operation, the oxygen index was higher in the patients given albumin (Plasbumin). It has been also ascertained that plasbumin is well tolerated, causes no adverse reactions, and produces no dose-dependent effect.

Adolescent↗
PubMed1991

Randomized comparative study of hemaccel vs. albumin infusion after total paracentesis in cirrhotic patients with refractory ascites.

Fifty-four cirrhotic patients with refractory ascites were treated with one-session large-volume paracentesis and randomly assigned to two groups. The first group was infused with human albumin, and the second group was infused with hemaccel at doses with comparable oncotic power. The two groups were compared for incidence of complications, recurrence of massive ascites after hospital dismissal and survival rate. The incidence of complications traditionally related to paracentesis, the probability of requiring readmission to the hospital for ascites (p = 0.48) and the probability of survival after entry into the study (p = 0.85) were the same for the two groups. A multivariate analysis of 16 parameters, including treatment modality, identified absolute unresponsiveness to diuretics as the only independent predictor of mortality. These results indicate that hemaccel infusion may safely replace albumin infusion after total paracentesis for cirrhotic patients with refractory ascites.

Aldosterone↗
PubMed1991

[Comparative trials of fluid gelatins on hemostasis in heart surgery in adults].

The purpose of this study was to compare, in adult cardiac surgery, the results of two gelatin substitutes (Plasmion and Haemaccel) especially for haemostasis and coagulation factors. Patients showing before operation any perturbation of blood parameters (anaemia, coagulation troubles) as well as patients suffering from serious complications or deceased in the postoperative period have been excluded. This study was realised with 54 patients randomised in two groups: group P (Plasmion); group H (Haemaccel). Anaesthesia was a diazanalgesia. Hemodilution was used in combination with autologous peroperative blood transfusion and reinfusion of residual blood from ECC after ultrafiltration. The two groups were statistically similar. In average, patients received the same gelatins quantity. The only remarkable findings were: a lesser decrease of platelets number per-ECC: a lesser fibrinogen level in postoperative period with Haemaccel.

Aged↗