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At least 559 records · Page 31Linked to original sources
PubMed1989

Plasma volume substitution does not inhibit plasma noradrenaline and muscle nerve sympathetic responses to insulin-induced hypoglycaemia in healthy humans.

Microelectrode recordings of muscle nerve sympathetic activity and measurements of venous plasma noradrenaline have indicated increased sympathetic outflow during acute hypoglycaemia. Plasma volume reduction during hypoglycaemia, as evidenced by increasing peripheral venous haematocrit might underly the sympathetic activation. To study the effect of prevention of plasma volume reduction during hypoglycaemia, saline containing albumin was infused intravenously in healthy adult volunteers during hypoglycaemia. Hypoglycaemia was induced by an intravenous injection of soluble insulin in a dose of 0.15 IU/kg body weight. Peripheral venous plasma noradrenaline concentrations were identical in experiments without and with plasma volume substitution. Muscle nerve sympathetic activity increased to the same extent during hypoglycaemia with and without plasma volume substitution. It is concluded that increased plasma noradrenaline concentrations and enhanced muscle nerve sympathetic activity during insulin-induced hypoglycaemia in man are not consequences of plasma volume reduction.

Adult↗
PubMed1985

[Does gelatin as a blood substitute selectively depress plasma fibronectin? A clinical randomized study].

In 18 adult patients, in a randomized way, 15 ml/kg of blood were replaced either by gelatin 5.5 pc or serum protein solution. 0,5, 4 and 24 h later there was only a significant difference between the two groups in total protein and serum albumin. The low molecular weight infection related proteins alpha-1-antitrypsin, immunoglobulin G and antithrombin III, as well as the high molecular weight proteins immunoglobulin M, plasma fibronectin and alpha-2-macroglobulin were at no time significantly different between the two groups. It is concluded that gelatin as a plasma substitute does not impair the opsonising effect of plasma fibronectin upon the reticuloendothelial system.

Adult↗
PubMed2001

Plasma protein loss during surgery: beneficial effects of albumin substitution.

Plasma protein loss during abdominal surgery is a known phenomenon, but its possible pathophysiological relevance has remained unknown. The present study evaluates the effects of albumin substitution on systemic and local hemodynamics and cellular interactions in the mesenteric microcirculation. Rats underwent median laparotomy and exteriorization of an ileal loop for intravital microscopy of the mesenteric microcirculation. Plasma protein concentrations, systemic and local hemodynamics were recorded during the follow up period, with or without albumin substitution. Depending on the time course of plasma protein loss in control experiments, 80% of the calculated protein loss was infused during the first 2 h of surgery, and the other 20% over the following 5 h of intravital microscopy. The control group received a continuous infusion of normal saline. Plasma protein loss was mainly due to loss of albumin. A significant increase in adherent and rolling leukocytes was observed during the course of mesenteric exteriorization, which was almost entirely reversed by albumin replacement. Albumin substitution led to stabilisation of mean arterial pressure and abdominal blood flow and also attenuated reductions in arterial base excess. Albumin infusions to replace plasma protein loss may be a simple and effective measure to attenuate microcirculatory disturbances and may be of benefit in patients undergoing abdominal surgery.

Abdomen↗
PubMed1980

[Significance of postoperative substitution of plasma proteins].

In the course of a pilot study 30 patients, who had to undergo extensive urological-abdominal surgery, were randomized and divided into two groups. One group received 500 ml of the stored serum Biseko on the day of operation as well as on the first postoperative day, the other group was given a placebo. The two groups were compared with regard to their complications rates (wound healing disturbance, respiratory disturbance on account of septicemia). It turned out, that there occurred clearly less complications in the group treated with Biseko than in the control group.

Humans↗
PubMed1990

Filtration of fresh frozen plasma used as substitution fluid in plasma exchange in order to remove microaggregates.

Freshly melted fresh frozen plasma (FFP) contains a large number of particles smaller than 20 microns in diameter. These particulate materials (microaggregates) consist of aggregated triglyceride-rich lipoproteins (LA) and precipitable aggregates closely resembling fibrin (FA). Both LA and FA injected into a rat's tail vein were trapped in the lung and formed emboli in the pulmonary arterioles. To prevent the passage of these microaggregates into the systemic circulation, a new circuit was devised for plasma exchange containing a filter with a pore size of 0.2 microns. In 17 patients with fulminant hepatitis who received plasma exchange transfusions and subsequently died and were autopsied, the incidence of pulmonary complications was significantly lower in the 12 patients who received filtered FFP. According to these results, the possibility of pulmonary complications due to micro-embolism developed by microaggregates in FFP should be taken into account when a large amount of FFP is repeatedly infused into critically ill patients.

Animals↗
PubMed1983

Blood substitutes: where are we?

Plasma volume expanders exist and are available. Balance salt solutions are preferred for initial resuscitation. Albumin should be avoided. Synthetic coagulation factors are not available. They exist because proper component therapy creates them to be stored for selective use. A substitute for the prime function of blood--oxygen delivery by the red cell--does not yet exist. Its clear that one is needed; the form is not yet identified. Fluorocarbon emulsions have a certain chemical cleanliness that makes them appealing, yet there are many unanswered questions, especially as to oxygen-carrying capacity and toxicity. Fluorocarbons have been pushed to clinical testing before their time. Chemically modified stroma-free hemoglobin continues to evolve and develop as a useful blood substitute. Most of the early problems seem to have been resolved and a third generation of molecules, the second set of modifications, is promising.

Animals↗
PubMed1982

The relationship between plasma membrane lipid composition and physical-chemical properties. III. Detailed physical and biochemical analysis of fatty acid-substituted EL4 plasma membranes.

Murine leukemia EL4 cells were modified by supplementation of culture media with fatty acids for 24 h. A plasma membrane-enriched fraction was prepared from substituted and normal cells. Analyses were performed to determine fatty acyl composition, phospholipid headgroup composition and cholesterol content. The two major membrane phospholipids, phosphatidylethanolamine (PE) and phosphatidylcholine (PC) were isolated by thin-layer chromatography and ESR measurements were done on liposomes prepared from these lipids as well as on the intact plasma membrane preparations. Slight perturbations in overall plasma membrane lipid composition were observed when EL4 cells were supplemented with a single exogenous fatty acid. This may be consistent with the idea that the incorporation of exogenous fatty acid induces compensatory changes in membrane lipid composition. On the other hand, we observed no significant difference in two ESR motional parameters between the unsubstituted control and various fatty acid-substituted plasma membranes. ESR measurements carried out on PE and PC liposomes derived from 17:0- and 18:2c-substituted membranes also failed to detect major differences between these liposomes and those made from normal EL4 phospholipids. In the case of liposomes prepared from 18:2t,-substituted membranes, the order parameter was significantly changed from the normal. However, the change was in opposite directions in PE and PC, perhaps accounting for the fact that no change parameter is seen in intact 18:2t-substituted plasma membrane. Measurements of order parameter (S) in mixed lipid vesicles showed that at up to 50 mol% mixture of a synthetic PC with plasma membrane PC, the value of S was only marginally different from that of the plasma membrane PC vesicles. We interpret these data as an indication that the two ESR parameters used are not sufficiently sensitive to detect changes due to modifications of the acyl chain composition of a complex biological membrane.

Animals↗
PubMed1987

[Comparative study of the modification of blood, blood coagulation, cardiovascular circulation by 3% modified, fluid gelatins and 6% low-molecular weight hydroxyethyl starch].

A randomized, comparative study with 3% modified fluid gelatine and 6% low molecular hydroxyethylstarch has been made on 87 patients of an intensive care unit. Both plasma substitutes were well compatible to the patients. The erythrocyte sedimentation rate was accelerated significantly by both plasma substitutes. This effect was at a maximum after 24 h and in the gelatine group it was percental about three times stronger, referred to the base line level in this group. In the hydroxyethylstarch group after 12 h the thrombocyte cell number decreased about 10.3%, referred to the base line, in the gelatine group the decrease was only 1.5% at the same time. At the chemical parameters there were no more differences between the two substitutes. Both plasma substitutes showed a mean effect of 4 h on plasma volume, referred to the changes of central venous pressure. The gelatine substitute showed a significant rise in blood pressure after end of infusion, the hydroxyethylstarch substitute did not. Both substitutes showed a rise in diuresis with a delay of 1 h. There were no differences between both solutions in the diuretic effect after infusion.

Blood↗
PubMedDate not supplied

[Clinical evaluation of hydroxy-ethylated starch (preparation HAES)].

Hydroxy-ethylated starch (HAES-Fresenius) has been evaluated clinically at the Department of Anesthesiology and Intensive Care, Medical Academy in Warsaw. This plasma substitute is used in several countries as plasma substitute similar to dextran but of better properties. Results of our studies have shown, that HAES is worth its opinion. It is quite good plasma substitute of favourable effect on tissue perfusion. The above features together with a wide therapeutical margin and the lack of any effect on blood coagulation place HAES over dextran plasma substitutes. This preparation should have wider use in Poland.

Evaluation Studies as Topic↗
PubMed1991

[Immunoglobulin deficiency after repeated plasmapheresis].

In 10 patients with Guillain-Barré syndrome the level of globulins and immunoglobulins before and after plasmapheresis was investigated. As a plasma substitute either PPL (in 8 patients) or a plasma substitute solution rich in immunoglobulins (in 2 patients) was used. When plasma was substituted with PPL, the globulins and immunoglobulins dropped to a mean of 40% of the initial value (range 30-60%) after the first plasmapheresis. With daily or alternate day plasmapheresis, the globulins only partially recovered. Before the second plasmapheresis they were still reduced to a mean of 50% (range 20-50%), and dropped further with ongoing exchanges to a mean of 33% (range 20-50%) as measured before the third plasmapheresis. Accordingly, there was a loss of immunoglobulins of similar magnitude. With the use of a plasma substitute solution rich in immunoglobulins (IRP), globulins could be maintained at normal levels. The lowest immunoglobulin values measured after plasmapheresis were 6 g/l (normal range 8-17 g/l). One patient developed gram-negative septicaemia after plasmapheresis with PPL, possibly due to a low immunoglobulin concentration. We conclude that a plasma substitute solution rich in immunoglobulins should be used for therapeutic plasmapheresis in order to maintain physiological immunoglobulin concentrations.

Adult↗