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At least 19 recordsLinked to original sources

Colloid solutions for fluid resuscitation.

BACKGROUND: Colloids are widely used in the replacement of fluid volume, however doubts remain as to their benefits. Different colloids vary in their molecular weight and therefore in the length of time they remain in the circulatory system. Because of this and their other characteristics, they may differ in their safety and efficacy. OBJECTIVES: To compare the effects of different colloid solutions in patients thought to need volume replacement. SEARCH STRATEGY: The Cochrane Injuries Group specialised register, The Cochrane Controlled trials register (all years), MEDLINE (1994-98), EMBASE (1974-98) were searched. Bibliographies of trials retrieved were searched and drug companies manufacturing colloids were contacted for information. SELECTION CRITERIA: Randomised and quasi randomised trials comparing colloid solutions in critically ill and surgical patients thought to need volume replacement. The main outcomes measured were death, amount of whole blood transfused and incidence of adverse reactions. DATA COLLECTION AND ANALYSIS: Two authors independently extracted the data and assessed the quality of the trials. MAIN RESULTS: 46 trials met the inclusion criteria, with a total of 2884 participants. Many of the trials were small. In the majority of trials quality was poor or uncertain. Deaths were obtained from 27 trials. Twenty three trials recorded the amount of blood transfused, however quantitative analysis was not possible due to skewness and variable reporting. Thirteen trials recorded adverse reactions, but none occurred. For albumin or PPF versus hydroxyethyl starch (HES) 20 trials reported mortality. The pooled relative risk (RR) was 1.17 (95% CI 0.91, 1.50). For albumin or PPF versus gelatin 3 trials reported mortality. The RR was 0.99 (0.69, 1.42). For gelatin vs HES 3 trials reported mortality, RR was 0.97 (0.65, 1.44). RR was not estimable in the albumin vs dextran, gelatin vs dextran, and HES vs dextran groups. REVIEWER'S CONCLUSIONS: From this review, there is no evidence that one colloid solution is more effective or safe than any other, although the confidence intervals are wide and do not exclude clinically significant differences between colloids. Larger trials of fluid therapy are needed if clinically significant differences in mortality are to be detected or excluded.

Blood Proteins↗

Plasma colloid osmotic pressure during open-heart surgery using non-colloid or colloid priming solution in the extracorporeal circuit.

Two different priming solutions for the heart-lung machine were compared in 14 patients during aortic valve replacement. Colloid osmotic pressure (COP), and albumin in plasma, blood erythrocyte volume fraction (B-EVF) and arterial oxygen tension (PaO2) (FIO2 = 1.0) were followed before, during and after perfusion. The two priming solutions were 2,000 ml Ringerdex (7 patients) or 1,800 ml Ringerdex + 200 ml 20% albumin (7 patients). COP and B-EVF were normal before bypass. After 10 min on bypass, when about 1,000 ml of crystalloid cardioplegic solution had been given, COP was reduced by about 50% and B-EVF fell to 23%, indicating a small loss of water from the circulation when compared with in vitro dilution curves. COP was slightly lower in the non-colloid group (p less than 0.02). Both COP and B-EVF remained unchanged during perfusion, despite transfusion from the heart-lung machine of a mixture of blood and crystalloid solution with a calculated very low COP (6 mmHg) and B-EVF (15%). After perfusion the restitution of COP and B-EVF was rapid and parallel. Both returned to normal levels after 2 hours. There was a good correlation between COP and albumin measured in the same plasma samples (r = 0.83, p less than 0.001). At one hour after bypass PaO2 (FIO2 = 1.0) tended to decrease in the non-colloid group, compared with preperfusion level. 40 g of albumin was a too small amount of colloid to diminish substantially the reduction of COP during perfusion. The unchanged levels of COP and B-EVF during perfusion, despite further dilution as well as the parallel normalization after perfusion, can only be explained by loss of water from the circulation.

Adult↗

Melting transition in a quasi-two-dimensional colloid suspension: influence of the colloid-colloid interaction

We report the results of a study, using digital video microscopy, of the melting transition in a quasi-two-dimensional suspension of uncharged silica spheres. This system was chosen to further test the dependence of the two-dimensional melting transition on the functional form of the colloid-colloid interaction. Our experimental data show that the solid phase undergoes a first order transition directly to the liquid phase. The system studied yields no evidence of the existence of a hexatic phase interpolating between the solid and liquid phases in the melting process.

Journal Article↗

Migration of colloids in discretely fractured porous media: effect of colloidal matrix diffusion.

Numerical simulations of colloid transport in discretely fractured porous media were performed to investigate the importance of matrix diffusion of colloids as well as the filtration and remobilization of colloidal particles in both the fractures and porous matrix. To achieve this objective a finite element numerical code entitled COLDIFF was developed. The processes that COLDIFF takes into account include advective-dispersive transport of colloids, filtration and remobilization of colloidal particles in both fractures and porous matrix, and diffusive interactions of colloids between the fractures and porous matrix. Three sets of simulations were conducted to examine the importance of parameters and processes controlling colloid migration. First, a sensitivity analysis was performed using a porous block containing a single fracture to determine the relative importance of various phenomenological coefficients on colloid transport. The primary result of the analysis showed that the porosity of the matrix and the process of colloid filtration in fractures play important roles in controlling colloid migration. Second, simulations were performed to replicate and examine the results of a laboratory column study using a fractured shale saprolite. Results of this analysis showed that the filtration of colloidal particles in the porous matrix can greatly affect the tailing of colloid concentrations after the colloid source was removed. Finally, field-scale simulations were performed to examine the effect of matrix porosity, fracture filtration and fracture remobilization on long-term colloid concentration and migration distance. The field scale simulations indicated that matrix diffusion and fracture filtration can significantly reduce colloid migration distance. Results of all three analyses indicated that in environments where porosity is relatively high and colloidal particles are small enough to diffuse out of fractures, the characteristics of the porous matrix that affect colloid transport become more important than those of the fracture network. Because the properties of the fracture network tend to have greater uncertainty due to difficulties in their measurement relative to those of the porous matrix, prediction uncertainties associated with colloid transport in discretely fractured porous media may be reduced.

Colloids↗

Preparation of rhenium-188-tin colloid as a radiation synovectomy agent and comparison with rhenium-188-sulfur colloid.

As a generator-produced beta-emitting radionuclide, the importance of 188Re for radionuclide therapy is increasing rapidly. We prepared 188Re-tin colloid and compared its properties with 188Re-sulfur colloid. Labeling efficiencies reached >98% for tin colloid at 2 h and 89-94% for sulfur colloid at 3 h. All the preparations were stable for 72 h in water, serum, and synovial fluid. If labeled at higher temperature, the particle size of tin colloid increased. The residual radioactivity of 188Re-sulfur colloid in disposable polypropylene syringes after injecting mice was high (62.0+/-7.0%) due to its hydrophobic nature, while that of 188Re-tin colloid was low (2.9+/-1.6%). Although both 188Re-tin colloid and 188Re-sulfur colloid might be useful for radionuclide therapy, we conclude that 188Re tin colloid is more advantageous over 188Re sulfur colloid, due to higher labeling efficiency, control of the particle size, and lower residual activity in the injection syringes.

Animals↗

Normal appearance and reproducibility of liver-spleen studies with Tc-99m sulfur colloid and Tc-99m microalbumin colloid.

In order to determine the normal biodistribution and reproducibility of Tc-99m sulfur colloid and Tc-99m microalbumin colloid, each of ten normal subjects was studied twice with each of the two agents. In overexposed delayed analog images of the anterior chest, some thyroid radioactivity was demonstrated in all of 20 microalbumin colloid studies and in none of 20 sulfur colloid studies; lung radioactivity was seen in 19 of 20 (95%) sulfur colloid studies and in none of the microalbumin colloid studies (both p less than 0.001). Delayed digital images showed that the sulfur colloid gave a higher lung-to-heart ratio, a higher lung-to-liver ratio, and a lower bone marrow-to-liver ratio compared with microalbumin colloid (all p less than 0.05). In general, reproducibility was poor for both agents. We conclude that while there are some differences between these two radiocolloids, the differences do not indicate a superiority of the newer Tc-99m microalbumin colloid over the established Tc-99m sulfur colloid for liver-spleen imaging.

Adult↗

Reaction of metallotetraphenylporphyrins on hydroxyl-modified silver colloid and Ag2O colloid by surface-enhanced Raman scattering.

This paper reports a novel reaction of metallotetraphenylporphyrins on hydroxyl-modified silver colloid and Ag2O colloid. Surface-enhanced Raman spectra of Ag(II) and Cu(II) complexes of tetraphenylporphyrin (TPP) adsorbed on the hydroxyl-modified Ag colloid and Ag2O colloid have been studied. The time-dependent SERS spectra of MTPP (M = Ag, Cu) on hydroxyl-modified Ag colloid were recorded and dramatic change on SERS spectra was observed. The final spectra were found to be strikingly different from the corresponding normal Raman spectra (NRS), with the appearance of new Raman bands at 1614. 1417, 947, 674 and 292 cm(-1). The UV-visible absorption spectrum of MTPP on hydroxyl-modified Ag colloid exhibits a broad shoulder near 460 nm. Similar spectral phenomena were also observed for AgTPP and CuTPP adsorbed on Ag2O colloid. The observed spectral alterations were ascribed to new species formation due to the irreducible oxidation of MTPP on the colloids.

Colloids↗

Influence of crystalloid versus colloid infusion on peripartum colloid osmotic pressure changes.

Plasma colloid osmotic pressure acts to retain fluid in the intravascular space. Intravenous crystalloids have been identified as one of the major factors contributing to the consistent peripartum decline in colloid osmotic pressure. This study was undertaken to compare the effect of two crystalloid infusions (1000 and 2000 mL Plasma-Lyte A) and a colloid infusion (1000 mL 5% albumin) on the peripartum colloid osmotic pressure. Before elective cesarean section, 45 parturients received one of the three infusions. The lowest mean maternal colloid osmotic pressure (16.6 +/- 1.1 mmHg, P less than .05 compared with baseline) occurred in the 2000-mL crystalloid infusion group eight to 16 hours postpartum. Although the colloid osmotic pressure fell in all groups postpartum, this reduction was significantly (P less than .05) less during the first 24 hours in the colloid infusion group. Minimizing this disruption of the colloid osmotic pressure to pulmonary capillary wedge pressure gradient may be clinically important in selected patients.

Cesarean Section↗

Colloidal alpha-stannic acid and negative iron colloid as differential electron stains for surface proteins.

Colloidal alpha-stannic acid and a negative iron colloid obtained from ferric hydroxide and potassium ferrocyanide, both negative sols being stable within a wide pH range, were refined as surface protein electron markers. Because of the relatively small size of its particles, colloidal alpha-stannic acid was used for staining all surface proteins. According to the pH at which the negative iron colloid was applied, it revealed either all surface proteins, or because of its large colloidal particles, stained basic proteins. This differential staining capability of the iron colloidal has been demonstrated previously on various control preparations (Puvion E, Blanquet PR: J Microsc 12:171, 1971). Controls on the affinity of the two colloids to surface amino groups were carried out on rat liver, mouse fibroblasts, HeLa and KB cells, Ehrlich and Zajdela ascites cells subjected to prior enzymatic and chemical treatments (incubation with neuraminidase or phospholipase C, esterification, acetylation or lipid extraction). At any pH below 9, the two sols stained proteins in the outer hydrophilic leaflet of esterified cells with relative selectivity, but the alpha-stannic acid showed them more accurately. The iron sol did reveal at high pH protein components of high isoionic point on the surfaces of rat hepatocytes and ascites cells which had only been treated with neuraminidase.

Animals↗

Pulmonary oxygenation, central haemodynamics and glomerular filtration following cardiopulmonary bypass with colloid or non-colloid priming solution.

Plasma colloid osmotic pressure (COP), blood erythrocyte volume fraction (B-EVF), arterial oxygen tension at an inspired oxygen concentration of 30% (PaO2 (FIO2 0.3)), cardiac index, stroke volume, arterial mean pressure, left atrial mean pressure, pulmonary av-difference of oxygen (Ca-v O2) and creatinine clearance were studied in 16 patients during isolated aortic valve replacement. The patients were divided into two groups with different priming solutions in the oxygenator. In the non-colloid group 2,000 ml of Ringerdex was used, while the colloid group had 1,600 ml of Ringerdex and 400 ml of albumin 20% (80 g). COP differed significantly between the groups (p less than 0.01) during and for 1 hour after bypass. The greatest reductions were 56% and 30%, respectively. Haemodilution (los B-EVF) was of longer duration in the colloid group. No differences between the groups were found with respect to pulmonary oxygenation, myocardial behaviour or glomerular filtration rate. Cardiopulmonary bypass produced no changes in cardiac index, stroke volume, arterial mean pressure, left atrial mean pressure, Ca-v O2 or creatinine clearance in either of the groups. PaO2 (FIO2 0.3) remained unchanged in the non-colloid group and showed a small but significant reduction (p less than 0.01) in the colloid group. No positive effects of a colloid prime were demonstrated.

Adult↗

Burn resuscitation: crystalloid versus colloid versus hypertonic saline hyperoncotic colloid in sheep.

OBJECTIVES: The present study was undertaken to assess the fluid balance and hemodynamic effects during the first 8 hrs of resuscitation in animals with a large body surface area burn, using lactated Ringer's solution, 6% hetastarch, and hypertonic saline dextran. DESIGN: A prospective, blinded, controlled, terminal study, using anesthetized animals. The initial baseline period was followed by scald injury, and three different treatment regimens were administered from coded bags to achieve a physiologic end point. SETTING: University laboratory. SUBJECTS: Eighteen female sheep (35 to 45 kg) were anesthetized with isoflurane. INTERVENTIONS: Test solutions (10 mL/kg of either lactated Ringer's solution, hetastarch, or hypertonic saline dextran) were infused 30 mins after the scald injury at a rate to restore and maintain the baseline oxygen delivery (DO2) value. MEASUREMENTS AND MAIN RESULTS: Cardiovascular hemodynamics, plasma sodium concentration, plasma colloid osmotic pressure, and fluid balance were measured before and after scalding and resuscitation. After the initial 10-mL/kg test solution dose was given, lactated Ringer's solution was infused to achieve the same end point of baseline DO2 for the remainder of the 8 hrs. The scald caused an initial 30% reduction in cardiac output, a 20% reduction in mean arterial pressure, and 10% to 15% increase in hematocrit. All three test solutions restored and maintained baseline DO2 within 1 hr. However, hetastarch and hypertonic saline dextran reduced the net fluid volume over 8 hrs by 48% and 74%, respectively, compared with lactated Ringer's solution. Edema in the burn wound was not affected by treatment, while hypertonic saline dextran reduced edema in nonburned skin compared with both lactated Ringer's solution and hypertonic saline dextran. Plasma colloid osmotic pressure was significantly higher in the hetastarch and hypertonic saline dextran groups. A continuous decrease in plasma sodium concentrations from baseline values (140 to 145 mmol/L) was measured in the lactated Ringer's solution and hetastarch groups (130 to 133 mmol/L) over 8 hrs. Plasma sodium concentrations in the group receiving hypertonic saline dextran were increased (150 to 155 mmol/L) at 4 hrs, but returned toward baseline by 8 hrs. CONCLUSIONS: Net volume loading can be reduced markedly by initial resuscitation of large body surface area burn injury using a colloid (hetastarch), and can be further reduced by use of hypertonic saline colloid. Hyponatremia was apparent in the isotonic crystalloid- and colloid-treated animals, but not in those animals treated with hypertonic saline colloid.

Animals↗

A better target-to-background activity ratio using a large-sized colloid compared to a nano-sized colloid for scintigraphy of the peripheral bone marrow. A study in mice and humans.

Small-sized radiocolloids with a diameter less than 100 nm (nanocolloids), reduce the confounding liver and spleen uptake compared to large-sized colloids at bone marrow scintigraphy. Consequently, nanocolloids are today generally used for this purpose. Such colloids, though, seem to produce considerable background activity, especially from the large vessels and the urinary tract. This has been studied in mice and humans using a nanocolloid and a large-sized colloid, both composed of human albumin. In mice, the findings confirm a lower relative and absolute uptake of the nanocolloid in the liver and spleen compared to the large-sized colloid, whereas the bone marrow activity relative to the activity of kidneys, heart, lungs, intestines and peripheral blood is higher for the large-sized colloid than for the nanocolloid. The latter was confirmed in humans who were examined by single photon emission computed tomography corrected for attenuation and scattering of photons. It is concluded that a large-sized colloid should be used for spot examination of a specific marrow region outside the liver and spleen, while a nanocolloid must be used when examining structures close to the liver and spleen as well as for depiction of the entire bone marrow.

Animals↗

Colloid and elastic fibre: ultrastructural study on the histogenesis of colloid milium.

Tissues peripheral to well-developed papules of colloid milium were chosen for biopsy and electron microscopy examination. Evidence was presented that colloid is derived from elastic fibres through sequential degenerative change. In the upper to middle dermis of the peripheral tissue, a number of abnormal masses in the vicinity of small colloid depositions were observed. Ultrastructurally, those abnormal masses were degenerating elastic fibres in which "electron-dense layers" of normal elastic fibre increased in amount, although their electron density diminished. Electron-light layers were gradually diminished in quantity. Degenerated elastic fibres finally became granulo-fibrillar and were indistinguishable from colloid. Many fibrils which closely resembled 10 nm tubular microfibrils of normal elastic fibre were observed in the granulo-fibrillar substance. Since one stage of the degeneration of elastic fibre which eventually leads to the formation of colloid milium was very similar to that of actinic elastosis, a direct role of sunlight in the formation of colloid milium is suggested.

Aged↗

Reaccumulation of thyroglobulin and colloid in rat and mouse thyroid follicles during intense thyrotropin stimulation. A clue to the pathogenesis of colloid goiters.

Since Marine's observations some 50 years ago, it has been generally accepted that colloid goiters invariably result from colloid repletion of originally hyperplastic goiters after cessation of the goitrogenic stimulus. However, clinical observations suggest that many goiters never go through a stage of hyperplasia, but are colloid-rich from the beginning. We have injected rats and mice with thyrotropin (TSH), three times a day for 4 d, while the animals were kept on an iodine-rich diet (HID). Additional groups of animals were fed an iodine-poor diet (LID) or a diet containing 0.15% propylthiouracil (PTU) or 1% sodium perchlorate (ClO4). At intervals, thyroid weight, DNA, iodine and thyroglobulin content, thyroglobulin iodination, and intracellular droplet formation were measured. Histologic sections were also prepared and stained with periodic acid Schiff. Furthermore, thyroxine concentration was measured in the serum. Thyroglobulin content dropped by approximately 30% in HID animals but by 60% in all other groups 1 d after starting TSH. Thereafter, thyroglobulin reaccumulation occurred and droplet formation correspondingly decreased despite continuous heavy TSH stimulation. The largest amount of thyroglobulin was reaccumulated in HID animals followed by the PTU/LID groups, whereas no reaccumulation was observed in the ClO4 group. Reaccumulation of thyroglobulin only occurred if there was concomitant organification of at least some iodine. The subsequent phases of depletion and reaccumulation of thyroglobulin were mirrored by the morphology of the follicular lumina, the staining properties of the colloid and the serum T4 concentration. These observations suggest that endocytosis gradually becomes refractory to continuous TSH stimulation if a certain minimal amount of iodine is available for organic binding. Thus, primarily colloid-rich goiters may form in the presence of continuously higher than normal thyrotropin levels without a previous stage of follicular hyperplasia. The view should be revised that accumulation of colloid and intense thyrotropin stimulation are mutually exclusive events.

Animals↗