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PubMed1988

Successful 72-hour cold storage of dog kidneys with UW solution.

Effects of three cold-storage solutions on kidney function in dogs were examined with the isolated perfused (IPK) kidney model and the autotransplant model. EuroCollins' (EC) solution, phosphate-buffered sucrose solution, and a new solution developed at the University of Wisconsin (UW) were studied. Kidneys were cold-stored for 48 hr or 72 hr. With the IPK model, cold storage for 48 hr or 72 hr in each of the three solutions caused creatinine clearance to decrease by 80%-90%. More protein was excreted by kidneys stored for 48 hr in PBS solution than by kidneys stored in EC or UW solution; protein excretion after 72 hr of storage was similar for kidneys stored in EC or UW solution. Sodium reabsorption decreased after 48 hr or 72 hr of storage, but was higher in kidneys stored in UW solution (83% and 56%, respectively) than in EC solution (52% and 22%, respectively). With the autotransplant model, 40% of the kidneys were viable after 48-hr storage in PBS solution, but 80% viable when stored in EC solution and 100% were viable when stored in UW solution. All kidneys were viable when stored for 72 hr in UW solution; none were viable when stored for 72 hr in EC solution. These results suggest that UW solution effectively preserves kidneys for 72 hr. We previously reported successful 72-hr pancreas preservation. Recently UW solution was able to preserve canine livers for 30 hr. Thus, this single solution appears to be effective for preserving all intraabdominal organs and may simplify cold storage of organs for transplantation.

Animals↗

PubMedDate not supplied

Sieving coefficients for small solutes during experimental peritoneal dialysis in rats.

A single 4-hour experimental peritoneal dialysis was performed in 6 normal Sprague-Dawley rats to investigate sieving coefficients (S) for small solutes during peritoneal dialysis. A modified 3.86% Dianeal solution with approximately the same concentrations of urea, sodium, and potassium as in the rat plasma (isochratic solution) was used to avoid diffusion of investigated solutes and to achieve sufficient ultrafiltration. As a control, a 4-hour peritoneal dialysis in 7 normal Sprague-Dawley rats was performed using the conventional 3.86% Dianeal solution. The infusion volume was 30 ml. A dilution of radioiodinated serum albumin was used to determine the intraperitoneal dialysate volume. S was calculated (1) from the mass and volume balances for the initial 30 min of the exchange with the isochratic solution (SI, isochratic method) and (2) by using a membrane model based on the thermodynamic theory of mass transport (SM). The diffusive mass transport coefficient KBD for the solutes investigated was estimated using the membrane model. The SI values for urea, sodium, and potassium were similar with the isochratic solution. For urea and sodium, the S values were within the physiological range 0-1, whereas the S values for glucose were close to 0 and for potassium were negative. SM for glucose, urea, and sodium using the conventional solution did not differ from the values obtained with the isochratic solution; however, SM for potassium was significantly lower than with the isochratic solution. SI and SM for potassium and sodium were correlated. The KBD values for glucose, urea, and sodium using the isochratic solution did not differ from the values obtained with the conventional solution, whereas the KBD values for potassium were significantly higher with the isochratic solution as compared with the conventional solution. We conclude that the net sieving coefficients SI and SM for urea and sodium were lower than unity in the rats dialyzed with the two solutions and did not differ from the previously reported S values measured in continuous ambulatory peritoneal dialysis patients with the isochratic solution. However, the transport of potassium was abnormal with the isochratic solution, suggesting mechanisms other than passive diffusive and convective potassium transport.

Animals↗

PubMed2001

The efficacy of low-pressure lavage with different irrigating solutions to remove adherent bacteria from bone.

BACKGROUND: Recent studies have suggested that high-pressure irrigation may have adverse effects on bone. However, the use of low-pressure irrigation may not remove all adherent bacteria from bone. The type of irrigating solution may be an important factor in the removal of adherent bacteria with pulsatile lavage. In this study, we compared the effects of various irrigating solutions on the number and function of osteoblasts and osteoclasts and we examined the effectiveness of these solutions in removing adherent bacteria from bone. METHODS: To examine the effect of irrigating solutions on the number and activity of osteoblasts, we isolated calvarial cells from newborn C57BI/6 mice and exposed the cells to equivalent concentrations of ethanol, povidoneiodine, liquid soap, antimicrobial wash (50 U/L of bacitracin), or chlorhexidine gluconate, for two, ten, or twenty minutes. The cells were then cultured in the presence of bone-nodule-enhancing medium (beta-glycerophosphate and ascorbic acid) for twenty-one days. The medium was changed every three or four days. Mineralized nodules were stained with alizarin red S, and osteoblasts were stained with a histochemical stain for alkaline phosphatase. Osteoclasts were identified with tartrate-resistant acid-phosphatase staining. In a second experiment, canine cortical tibiae were contaminated with Staphylococcus aureus for six hours and subjected to different irrigating solutions with or without low-pressure lavage. Bacterial colony-forming units were quantitated under each set of conditions. RESULTS: Each solution resulted in a time-dependent decrease in the number of calvarial osteoblasts and osteoclasts compared with that in the controls. The 1% soap solution resulted in greater preservation of both alkaline-phosphatase activity and bone-nodule formation than did the other solutions. Moreover, the soap solution preserved the number of osteoclasts to the greatest extent. The povidone-iodine and chlorhexidine-gluconate solutions resulted in the largest decline in bone-nodule formation, alkaline-phosphatase activity, and number of osteoclasts. Low-pressure pulsatile lavage with the soap solution removed the most bacteria from the contaminated tibia when compared with either the soap solution alone or low-pressure irrigation with saline solution. CONCLUSIONS: Our findings suggest that certain solutions may be more effective in removing bacteria from bone than mechanical irrigation with saline solution alone. Among the various solutions examined, the soap solution preserved the number and activity of osteoblasts the most. Low-pressure lavage with the soap solution resulted in the greatest removal of adherent bacteria from bone.

Animals↗

PubMed1999

Skin flap storage with intracellular and extracellular solutions containing trehalose.

To evaluate and compare the effects of IT-Kyoto (IT-K) solution (intracellular type) and ET-Kyoto (ET-K) solution (extracellular type) on long-term skin flap preservation (from 24-120 hours), Japanese white rabbits were used as an animal model and Euro-Collins (EC) solution was used as a comparative solution. A total of 180 animals were divided randomly into 15 groups (N = 12) for 24, 48, 72, 96, and 120 hours of flap storage in three solutions. The survival rate, weight change, and histological appearance of flaps were compared among the three solutions. The survival rates in the IT-K and ET-K solutions were the same: 100%, 100%, 100%, 92%, and 50% in flaps preserved for 24, 48, 72, 96, and 120 hours, which were higher (p < 0.01 in the 72-, 96-, and 120-hour groups) than those in the EC solution group: 100%, 75%, 33%, 8.3%, and 0%. The flap weight gain in the IT-K and ET-K solution groups was less than that in EC solution group (p < 0.01). Histologically, flaps in the IT-K and ET-K solution groups showed a better appearance than those in the EC solution group. It was concluded that in a rabbit model IT-K and ET-K solutions are superior to EC solution for long-term skin flap preservation, and the safe preservation period for IT-K and ET-K solutions is approximately 96 hours. It was also concluded that the effects of intracellular (IT-K)-type solution and extracellular (ET-K)-type solution on rabbit skin flap preservation are similar.

Animals↗

PubMed1991

Effect of sugars in the preservation solution on liver storage in rats.

We have performed 128 rat liver transplants in order to examine the effect of sugars in preservation solutions on cold storage of rat livers. Glucose (Mw. 180), sucrose (Mw. 348), and raffinose (Mw. 594) were tested. Rat livers were preserved at 4 degrees C for 12, 16, 18, and 24 h in standard Eurocollins solution (EC solution) (solution A) or in one of three modified EC solutions in which 194 mM/liter glucose in standard EC solution was replaced by 140 mM/liter of glucose (solution B), sucrose (solution C), or raffinose (solution D). The osmolarity of the modified solutions (solution B-D) was 320 mOsm/liter. Using standard EC solution (solution A), the 1-week survival rate of rats receiving livers preserved for 12, 16, 18, or 24 h was 6/8, 4/8, 1/8, and 0/4, respectively. With solution B, in which 194 mM/liter glucose was replaced by 140 mM/liter glucose, 1 week survivors following transplantation of livers preserved for 12, 16, 18 or 24 h were 4/8, 3/8, 2/8 and 0/4, respectively. Solution C, which was identical to solution A except for the replacement of 194 mM/liter glucose by 140 mM/liter sucrose, gave the following 1-week survival rates: 5/8 for 12 h, 5/8 for 16 h, 2/8 for 18 h, and 0/4 for 24 hours preservation, respectively. Using solution D, which differed from A in the replacement of glucose by 140 mM/liter raffinose, the 1-week survival rates of rats grafted with livers preserved for 12, 16, 18, and 24 h were 6/8, 5/8, 3/8 and 0/4, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

In vitro comparison of soaking solutions for rigid gas-permeable contact lenses.

The comfort of rigid gas-permeable contact lenses is influenced by multiple factors, including the composition of lens material and the presence of surface deposits and/or cleaning solution residues on the lens, as well as the direct effect of lens care solutions on the lens and eye. This study was designed to examine the comparative properties of several soaking solutions with respect to wettability, viscosity, and substantivity, which are essential to maintaining patient comfort. Solutions included in this trial were: OPTI-SOAK Conditioning Solution, Boston Advance Conditioning Solution, Boston Advance Conditioning Solution, Boston Conditioning Solution, Barnes-Hind Wetting and Soaking Solution, Duracare Conditioning, and Total Cleaning, Wetting & Soaking Solution. Wettability, as indicated by mean wetting angle, was determined and OPTI-SOAK Conditioning Solution, followed by Boston Advance and Boston Conditioning solutions, respectively, yielded superior results. For viscosity, OPTI-SOAK Conditioning Solution again provided the most favorable (highest) viscosity, followed by Boston Conditioning and Barnes-Hind solutions. With regard to substantivity, a measure of sustained wettability, Boston Conditioning Solution achieved the highest measurement, followed by OPTI-SOAK and Boston Advance solutions. On the basis of this in vitro evaluation, OPTI-SOAK Conditioning Solution provided the highest potential for patient comfort based on a combination of wettability, viscosity, and substantivity.

Contact Lens Solutions↗

PubMed2004

GSSI, a general model for solute-solvent interactions. 1. Description of the model.

A novel, semiempirical approach for the general treatment of solute-solvent interactions (GSSI) was developed to enable the prediction of solution-phase properties (e.g., free energies of desolvation, partition coefficients, and membrane permeabilities). The GSSI approach is based on the principle that all solution-phase processes can be modeled in terms of one or more gas-to-solution transfer processes. The free energy of each gas-to-solution transfer process is calculated as the sum of the free energy of cavity formation and the free energy of solute-solvent interaction. The solute's contributions to these free energies are modeled on the basis of various quantities computed from the solute's three-dimensional (3D) structure, whereas the solvent's contributions are modeled by empirically determined regression coefficients. More specifically, the free energy of cavity formation is modeled on the basis of the total solvent-accessible surface area of the solute. The enthalpy of solute-solvent interaction is modeled on the basis of intermolecular interaction potentials calculated at many uniformly distributed points on the solvent-accessible surface of the solute. The entropy of solute-solvent interaction is modeled on the basis of an effective number of rotatable bonds in the solute and by the regression coefficients characteristic of the solvent. The potential utility of the GSSI approach was demonstrated by modeling the free energy of gas-to-solution transfer for 111 solutes in water, 250 solutes in hexadecane, and 84 solutes in octanol.

Kinetics↗

PubMed1998

Efficacy of a glutamine-based oral rehydration solution on the electrolyte and water absorption in a rabbit model of secretory diarrhea induced by cholera toxin.

BACKGROUND: Glutamine is absorbed in the intestinal tract coupled with sodium and is the principal metabolic substrate for the enterocyte. Therefore, an oral rehydration solution containing this substance might provide an effective oral means of restoring electrolyte losses as well as speeding repair of mucosal damage. The objective of this work was to investigate the use of an oral rehydration solution based on glutamine in vivo in the perfused rabbit ileal loop model of secretory diarrhea induced by choleratoxin. METHODS: Phenolsulfonphthalein (PSP, 50 mg/l) was used as a nonabsorbable marker for calculations of net water and electrolyte transport. Solutions tested included: (a) a glutamine-based oral rehydration solution with 111 mmol/l glutamine, (Gln-ORS); (b) the oral rehydration solution recommended by the World Health Organization; (c) modified Ringer's solution. Choleratoxin (1 microg/ml) was injected into the lumen of the ileal rabbit segments for 30 minutes prior to the initiation of the perfusion. RESULTS: Choleratoxin induced significant secretion of sodium in the control modified Ringer's solution (10.8 +/- 2.95 vs -14.05 +/- 5.95 microEq/g/min, n = 10; p < 0.01) and of water (0.06 +/- 0.03 vs -0.15 +/- 0.06 ml/g/min, n = 10; p < 0.01) with a maximum effect at 60 minutes after initiation of perfusion. World Health Organization oral rehydration solution was able to significantly reduce the intestinal secretion of sodium (control with cholera = -14.34 +/- 2.18 vs oral rehydration solution with cholera = -0.50 +/- 0.48 microEq/g/min, n = 10; p < 0.01) and water (-0.15 +/- 0.02 vs -0.012 +/- 0.005 ml/g/min, n = 10; p < 0.01). For comparison, glutamine-based oral rehydration solution had an even greater effect on sodium and water absorption (glutamine-based oral rehydration solution with choleratoxin = 10.31 +/- 1.21 microEq/g/min, n = 5; p < 0.01 for sodium and 0.08 +/- 0.008 ml water/g/min; n = 5; p < 0.01). Choleratoxin did not change the effect of glutamine-based oral rehydration solution on sodium and water absorption (12.90 +/- -1.09 microEq sodium/g/min, n = 5; and 0.11 +/- 0.01 ml water/g/min; n = 5). In addition glutamine-based oral rehydration solution also induced a greater absorption of potassium and chloride in the intestinal ileal segments treated with choleratoxin compared with World Health Organization glutamine-based oral rehydration solution. CONCLUSIONS: These results demonstrate the superior efficacy of glutamine-based oral rehydration solution in electrolyte and water absorption compared with modified Ringer's control solution or even with World Health Organization-recommended oral rehydration solution.

Animals↗

PubMed1999

Electrolyte vs. glucose-electrolyte isotonic solutions for oral rehydration therapy in horses.

An isotonic electrolyte solution with a composition similar to equine sweat was compared to an isotonic glucose-glycine-electrolyte solution for oral rehydration therapy in exercising horses. Ten horses were dehydrated by using frusemide and allocated randomly to receive 4 different oral solutions: isotonic sweat-like electrolyte solution, half-strength hypotonic electrolyte solution, isotonic glucose-glycine-electrolyte solution, and plain water. Solutions were given by nasogastric tube using the same volume as the bodyweight lost by each horse. Blood samples were collected before and throughout 6 h of the rehydration period. Results showed that all solutions recovered pre-frusemide values of packed cell volume (PCV) and total plasma protein (TP) in a similar fashion. No changes for Na+ values were observed during the rehydration period when the isotonic sweat-like solution was used. However, a significant hyponatraemia was induced throughout rehydration when the other 3 solutions were given, especially when hypotonic solution and water were used. Osmolality values did not change when both isotonic solutions were administered; but a significant hypotonicity was observed when hypotonic solution and water were given. When the isotonic sweat-like solution was used, plasma Cl-, K+ and creatinine values recovered to premedication values significantly faster than the other 3 solutions. In conclusion, the isotonic sweat-like electrolyte was the best solution because it restored rapidly the fluid and plasma electrolyte imbalances. In contrast, the isotonic glucose-glycine-electrolyte solution impaired the plasma electrolyte imbalances.

Animals↗

PubMed2001

Effect of bicarbonate/lactate peritoneal dialysis solutions on human mesothelial cell proliferation ex vivo.

Peritoneal membrane suffers structural and functional changes over time on peritoneal dialysis (PD)--in part, owing to the dialysis solutions currently used. Low pH seems to be an important element associated with solution bioincompatibility. Bicarbonate-containing fluids open new perspectives on this issue. The present study compared the effects of bicarbonate/lactate (Bic/Lac) solution (25 mmol/L bicarbonate, 15 mmol/L lactate) and lactate (Lac) solution (40 mmol/L lactate) on mesothelial cell (MC) growth in culture. Eight stable PD patients were asked to collect peritoneal effluent from an 8-hour dwell on two separate days, within an interval shorter than one week. For the first dwell, Lac solution was infused; for the second dwell, Bic/Lac solution was instilled. Human MCs were isolated from the effluent, seeded in 25-cm2 tissue culture flasks, and grown ex vivo. Morphology of the cells was also evaluated. In all effluents, MCs were present in mean amounts of 26,939 +/- 21,267 cells (Bic/Lac) and 25,986 +/- 15,286 cells [Lac, p = nonsignificant (NS)]. Morphology of the MCs was similar with both solutions (87.5% typical). After initial culture, MCs from 6 patients using Bic/Lac (75%) and 3 patients using Lac (37.5%) reached confluence. At this time, the number of MCs from the 3 patients who showed MC growth with both solutions was slightly higher with Bic/Lac-buffered fluid (Lac: 1,154,125 +/- 213,333 cells; Bic/Lac: 1,198,291 +/- 806,713 cells). To summarize: 3 patients showed MC growth under both solutions; 3 patients showed MC growth only under Bic/Lac solution; and 2 patients showed no MC growth at all. After cells were seeded in 24-well plates, the MC growth curve was performed in 4 cases of Bic/Lac solution use and in 3 cases of Lac solution use. Although no significant differences were observed between the solutions, the final number of MCs obtained was higher with Bic/Lac solution use. In conclusion, MCs released into peritoneal effluent under bicarbonate/lactate-buffered peritoneal dialysis solution are associated with a greater ex vivo proliferation capacity than those released under lactate solution in the same patient. This finding may demonstrate better biocompatibility for Bic/Lac solution.

Bicarbonates↗

PubMed1981

Growth of bacteria and fungi in parenteral nutrition solutions containing albumin.

The ability of total parenteral nutrition (TPN) solutions containing albumin to support bacterial and fungal growth was studied. The following solutions were tested for microbial growth: (A) thioglycolate broth, (B) solution A with preservatives, (C) albumin 6.25 g in 500 ml 0.9% sodium chloride injections, (D) solution C with preservatives, (E) amino acid and dextrose TPN solution with magnesium sulfate and folic acid, (F) solution E with albumin 6.25 g in 500 ml, (G) amino acid and dextrose TPN solution with calcium gluconate and multivitamins, and (H) solution G with albumin 6.25 g in 500 ml. Each solution was inoculated with 1 X 10(5) bacteria/ml or 1 X 10(3) yeast/ml in 12 serial dilutions using minimum inhibitory concentration (MIC) plates. These were incubated at 37 degrees C for 48 hours, and cultures were visually rated on a scale of 0 (no growth) to 4 (maximal growth). Each culture was repeated for a total of 10 samples. Microbial growth was not affected by the low concentrations of preservatives available from the TPN additives. Undiluted TPN solutions were able to sustain fungal growth only. There was a significant increase in microbial growth in diluted TPN solutions containing albumin for S. aureus, C. albicans, T. glabrata, K. brier, S. marcescans, and E. coli. The presence of vitamins (solution G) impaired the ability of gram-negative bacteria to proliferate, and the addition of albumin (solution H) had no significant effect on the growth characteristics of the organisms in the solution. The presence of albumin had no effect on the growth of S. faecalis or Ps. aeruginosa. The addition of albumin to crystalline amino acid TPN solutions increases the potential of these solutions to support the growth of fungi and bacteria. Hence, it is recommended that albumin be administered separate from amino acid TPN solutions.

Albumins↗

PubMedDate not supplied

A lactobionate-based extracellular-type solution for donor heart preservation.

The University of Wisconsin solution, which contains the impermeant lactobionate and has an intracellular-type electrolyte composition, has been shown to improve donor heart preservation. Because a deleterious effect of the intracellular-type solutions has been reported, we evaluated a new lactobionate-based extracellular-type solution, by comparing it with University of Wisconsin solution and a crystalloid cardioplegic solution in 45 rabbit hearts. Hearts were arrested by infusion of these solutions and immersed in the same solution (lactobionate-based extracellular-type solution, University of Wisconsin solution) or in the lactated Ringer's solution (crystalloid cardioplegic solution) for 6 hours at 4 degrees C. A Langendorff circuit was used for reperfusion. Left ventricular compliance was better preserved with both lactobionate-based solutions than with the crystalloid cardioplegic solution. Adenosine triphosphate was best preserved with the lactobionate-based extracellular-type solution after arrest and after reperfusion, whereas reperfusion arrhythmias were less marked with the University of Wisconsin solution. These results suggest that lactobionate plays an important role in the preservation of ventricular compliance and that the lactobionate-based extracellular-type solution is preferable for adenosine triphosphate preservation. Further study will be required to assess the factors predisposing to reperfusion arrhythmias.

Adenine↗

PubMed1984

Importance of sodium ions in the protective effects of high-potassium, high-glucose solution on electromechanical activities in the guinea-pig myocardium.

The protective effects of high-K, high-glucose solution (GK solution) on electromechanical activity in the isolated guinea-pig ventricular muscle were studied. The basal test solution (basal GK solution) contained 30 mM KCl, 230 mM glucose and 4 mM NaHCO3, that is nominally Ca-free. Various types of GK solutions were also prepared by modifying the composition of this solution. When the muscle was exposed to the basal GK solution, the resting potential fell to about -40 mV, the muscle lost the excitability, and an irreversible contracture gradually developed. This contracture was prevented by elevating [Na]o above 60 mM. Reduction of [K]o to 20 mM, addition of EGTA (0.4 mM), or lowering the temperature (23 degrees C) also suppressed the above contracture. When the GK solution with high Na (106-115 mM NaCl added to basal GK solution in exchange for glucose) was applied, contractures frequently developed upon reintroduction of Tyrode solution (Ca-paradox-like phenomenon). Thus the Ca-free GK solution with 60 mM Na (56 mM NaCl added to basal GK solution in exchange for glucose) induced no contracture, either during or after the test period. Recovery of the action potential after this application was all but complete. On the other hand, addition of 0.9 to 1.8 mM Ca to this solution produced another type of contracture which was sensitive to verapamil. The cardioplegic effects of the Ca-free GK solution with 60 mM Na persisted under hypoxic conditions, and glucose appeared to play a significant role in preventing the hypoxia-related contracture. In contrast, the high-Na (110 mM Na) GK solution containing 0.2 to 0.5 mM Ca and Tyrode solution, both of which produced no contracture under normoxic conditions, did produce contractures under hypoxic conditions. Therefore, Ca-free GK solution containing an appropriate concentration (around 60 mM) of Na may protect the normoxic and hypoxic myocardium against intracellular Ca overload. The related mechanisms involved were discussed with special reference to membrane functions and intracellular Ca-regulating systems.

Action Potentials↗

PubMed1981

Thiamine destruction by sodium bisulfite in infusion solutions.

The degree of degradation of thiamine hydrochloride in sodium bisulfite-containing infusion solutions was investigated. Two amino acid and one electrolyte infusion solution containing sodium bisulfite and four infusion solutions (5 and 10% dextrose, Lactated Ringer's, and 0.9% sodium chloride injections) without sodium bisulfite were obtained in 500-ml glass or plastic containers. Three thiamine sources, two commercial multivitamin preparations, and one investigational multivitamin product were added to the infusion solutions. The percentage of added thiamine remaining after storage was determined in four experiments: (1) The investigational product was added to the infusion solutions with bisulfite, and the determinations were made after 24 hours of storage at room temperature (RT) under both light and dark conditions; (2) the two commercial multivitamin preparations were mixed with an amino acid solution containing bisulfite and the determination was made after 24 hours of storage at RT under dark conditions; (3) the investigational product was added to the infusion solutions with bisulfite, and the determinations were made after 2, 4, 6, 8, and 24 hours storage at 7 degrees C and following four hours at RT under dark conditions; and (4) the investigational product was added to the four infusion solutions without bisulfite, and the determinations were made after 24 hours of storage at RT under both light and dark conditions. In the infusion solutions containing bisulfite, the stability of thiamine was inversely related to the pH. In an amino acid solution at a pH of 6.5, only 3-8% of the added thiamine was found after 24 hours storage at RT, and only 37% was found after 24 hours at 7 degrees C. In the electrolyte solution with bisulfite (pH = 5), the percentages of thiamine remaining after 24 hours RT and 7 degrees C storage were 50 and 69%, respectively. Light exposure was not found to affect the stability of thiamine in the solutions containing bisulfite. In the infusion solutions without bisulfite, a minimal loss of thiamine occurred even though the pH range was 4.7-5.6. The degradation effect of light exposure was greater for the solutions stored in plastic than in glass. Infusion solutions containing bisulfite were found to be unsuitable vehicles for the administration of vitamin formulations containing thiamine. If a patient must receive multivitamins in infusion solutions with bisulfite, the solutions should be used immediately after their preparation, and the patient should be monitored for signs of thiamine deficiency.

Drug Incompatibility↗

PubMed2000

Biocompatibility of new peritoneal dialysis solutions: clinical experience.

The successful development of peritoneal dialysis (PD) during the last two decades has been made possible by using well-established glucose-based solutions with lactate as buffer. On the other hand, awareness has been increasing about the potentially negative effects of the high concentrations of glucose and lactate, and the low pH of conventional PD solutions. This awareness has prompted an intensive effort to search for and test alternative solutions. As a result, three new, more biocompatible solutions-containing either less glucose or less lactate--are available. Amino acid-based solution uses amino acids instead of glucose as the osmotic agent; it is indicated for treatment of malnutrition. The higher pH and absence of glucose in this solution may prevent alterations of the peritoneal membrane caused by acidity and high glucose concentrations. Bicarbonate/lactate-buffered solution contains a physiologic concentration of bicarbonate and a reduced concentration of lactate; it also has a physiologic pH and markedly reduced levels of glucose degradation products (GDPs). Icodextrin-based solution contains icodextrin as the osmotic agent; it is indicated for long dwells, delivering sustained ultrafiltration for more than 16 hours. This iso-osmolar glucose-free solution may reduce peritoneal membrane alterations caused by glucose or the hyperosmolality (or both) of conventional solutions. Clinical experience of the new solutions is now extensive, and their efficacy and safety are well documented. It therefore seems appropriate to state that we have entered a new era of PD therapy. Each of the new solutions may be less damaging to the peritoneal membrane than conventional solution. In addition, they permit better management of malnutrition and fluid status, and may thus help to improve PD patient survival. Although the effects of each of these new solutions have been well described, clinical documentation of the combined use of these new biocompatible PD solutions is still insufficient. However, the results of studies are expected, during the coming years, to support the combined use of the new solutions as the preferred standard practice for PD.

Amino Acids↗

PubMed2001

Comparison of effectiveness of intracellular and extracellular preservation solution on attenuation in ischemic-reperfusion lung injury in rats.

BACKGROUND: Human lung allografts can only be preserved for 6 hours. Experimental interventions that reduce ischemia-reperfusion (I/R) lung injury can be used to improve the properties of the preservation solution. The best solution for lung preservation is still a matter of controversy. The purpose of this study was to compare the protective effects of various solutions on I/R lung injury in Sprague-Dawley rats. METHODS: The following solutions were compared: a physiological salt solution; an intracellular preservation solution (the University of Wisconsin Solution, UW); an extracellular preservation solution (EP3); and the extracellular preservation solution with the addition of various protective agents--EP3 plus dexamethasone (Dex) (EP3-a), plus glutathione (GLU) and allopurinol (ALL) (EP3-b), and EP3 plus GLU, ALL, lactobionate (LACT), and raffinose (RAF) (EP3-c). I/R lung injury was induced by ischemia for either 45 or 60 minutes, followed by reperfusion for 60 minutes. Hemodynamic changes, lung weight gain (LWG), and capillary filtration coefficients were measured. RESULTS: Both EP3 and UW preservation solutions had partial attenuation effects on I/R lung injury, but UW produced a better attenuation effect than EP3. Use of modified EP3 solutions containing either protective agents (GLU, ALL, or Dex) or impermeants (LACT and RAF) improved the ability of EP3 to reduce I/R lung injury. The LWG using the modified EP3-c solution was the lowest among all groups. UW induced pulmonary hypertension. After I/R challenge, pulmonary arterial pressure with EP3-c was lower than with UW. Based on a lower LWG and the changes in hemodynamics, EP3-c is a better lung preservation solution than UW and EP3. CONCLUSIONS: Based on the attenuation of I/R injury, we conclude that there is no significant difference between intracellular UW and extracellular (EP3-a, EP3-b) preservation solutions in this rat model, but the addition of protective agents and impermeants to the solution are important. The findings suggest that EP3-c might be a better lung preservation solution than UW.

Adenosine↗

PubMedDate not supplied

Peritoneal fluid and solute transport with different polyglucose formulations.

OBJECTIVE: To study peritoneal fluid and solute transport characteristics using different polyglucose solutions with and without the addition of glucose. DESIGN: Thirty-one rats were divided into three groups. A 4-hour dwell study with frequent dialysate and blood samples was performed in each rat using 25 mL of 7.5% polyglucose solution (PG, n = 11), 7.5% polyglucose + 0.35% glucose solution (PG1, n = 12), or 3.75% polyglucose + 1.93% glucose solution (PG2, n = 8). Radiolabeled human albumin (RISA) was added to the solutions as an intraperitoneal volume (i.p.V) marker. In addition, polyglucose degradation was evaluated ex vivo over 24 hours. EXPERIMENTAL ANIMALS: Thirty-one male Sprague-Dawley rats (300 g) were used. MAIN OUTCOME MEASURES: Fluid and solute (glucose, urea, sodium, potassium, and total protein) transport characteristics as well as changes in dialysate osmolality were evaluated. RESULTS: The i.p.V was higher in the PG1 and PG2 groups than in the PG group during the first 2 hours of the dwell. The i.p.V, in fact, decreased during the first hour of the dwell in the PG group. However, the net ultrafiltration at 4 hours tended to be lower in the PG2 (3.2 +/- 1.5 mL) group compared to the PG (5.1 +/- 2.3 mL) and the PG1 groups (5.2 +/- 2.1 mL) (p = 0.07), and no significant difference was found between the PG and PG1 groups. Adding glucose to the PG solution increased the RISA elimination rate (KE, representing the fluid absorption rate from the peritoneal cavity): 25.5 +/- 8.2, 37.5 +/- 12.2, and 42.5 +/- 8.9 microL/min for the PG, PG1, and the PG2 group, respectively, p < 0.01. Dialysate osmolality (D[OS]) increased with the dwell time in the PG and PG1 groups but decreased in the PG2 group.The increase in D(OS) was partially due to the degradation of glucose polymer, which was supported by the marked increase in osmolality over 24 hours of incubation of PG solution with peritoneal fluid, ex vivo. The diffusive mass transport coefficient for the investigated solutes did not differ among the three groups (except for glucose, which was significantly lower in the PG group). The sieving coefficient for sodium was significantly higher in the PG group compared to the PG1 group (p < 0.05). CONCLUSION: Our results suggest that, although there was an initial decrease in the intraperitoneal dialysate volume, significant amounts of fluid can be removed by polyglucose solution during a single 4-hour dwell in rats, despite the low osmolality of the solution. The positive fluid removal induced by the PG solution is partially due to the lower fluid absorption rate associated with this solution and may, to some extent, also be due to the degradation of glucose polymer within the peritoneal cavity, resulting in increased dialysate osmolality. The addition of glucose to the polyglucose solution does not seem to improve ultrafiltration in a 4-hour dwell in the rat model. However, the peritoneal fluid absorption rate may be increased, and peritoneal transport of glucose and sodium may be altered, by adding glucose to the polyglucose solution.

Animals↗

PubMed2003

Preservation of mouse liver tissue during cold storage in experimental solutions assessed by x-ray microanalysis.

The increasing use of organs for transplantation necessitates the development of optimal preservation techniques. The goal of this study was to investigate changes in elemental content in mouse liver cells during cold storage by x-ray microanalysis in parallel with morphologic studies. Tissue was stored at 4 degrees C for 4 to 12 hours in normal Krebs-Ringer solution (high sodium/potassium ratio), modified Krebs-Ringer solution (low Na(+)/K(+) ratio), Euro-Collins solution, University of Wisconsin (UW) solution, or seven modified versions of the UW solution. Incubation of liver in normal Krebs-Ringer solution caused a significant increase in sodium and decrease in potassium concentrations in contrast to incubation in other solutions. The concentration of sodium, potassium, and chlorine in the cells closely followed the concentration in the storage solution, indicating that the intracellular concentration of these ions during storage is entirely dependent on diffusion processes. The calcium concentration was independent of the storage solution used. Studies by light and transmission electron microscopy showed good preservation of hepatocytes after storage for 8 and 12 hours in UW solution and its variants, modified Krebs-Ringer solution and Euro-Collins solution, but showed moderate damage to mitochondria and swelling of the endoplasmic reticulum in normal Krebs-Ringer solution. In addition, damage to the sinusoidal endothelial cells was observed after 4 hours in normal Krebs-Ringer solution and after 8 to 12 hours in the other solutions. In conclusion, the only factor determining the intracellular concentration of diffusible ions after cold tissue storage is the ionic composition of the extracellular medium. X-ray microanalysis provides an objective method for assessing whether the intracellular ionic composition of tissue is maintained during storage.

Adenosine↗