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At least 19 recordsLinked to original sources
PubMed1985

Blood and plasma substitutes--plasma expansion and oxygen transport properties.

Because of the risks and costs of blood and blood product infusion, developing blood and plasma substitutes is of significance. Two currently utilized substances, dextran and hydroxyethyl starch, are effective colloid plasma expanders. The dextrans have properties that improve microcirculatory blood flow but are associated with several possible adverse effects. Hydroxyethyl starch is a well-tolerated agent that has efficacy similar to albumin but at a lower cost. Two newer substances, perfluorocarbons and stroma-free hemoglobin, are being developed to improve oxygen transport as well as plasma expansion.

Blood Substitutes↗
PubMed1990

Effects of different plasma substitutes on plasma fibronectin concentrations in patients undergoing abdominal surgery.

Plasma fibronectin is important for host defences as an opsonin of the mononuclear phagocyte system (MPS). The effects of three types of plasma substitutes, crystalloid, gelatin and dextran solutions, on plasma fibronectin levels were studied in patients undergoing abdominal surgery in relation to serum total protein and serum C-reactive protein (CRP) levels. Plasma fibronectin levels decreased during induction of anaesthesia and infusion of an electrolyte solution before infusion of the plasma substitute, and they were further decreased during operation after infusion of plasma substitutes and remained depressed on the first postoperative day in all study groups (P less than 0.05-0.01). In the crystalloid and dextran groups, plasma fibronectin levels exceeded preoperative levels by the 4th-5th postoperative day (P less than 0.05-0.01), but in the gelatin solution group they remained depressed (P less than 0.01). Serum total protein levels remained lower than preoperative values throughout the study period (P less than 0.05-0.01), whereas CRP levels were many times higher on days 1 and 4-5 postoperatively in all groups (P less than 0.01).

Abdomen↗
PubMed1989

[The problems of plasma substitution in performing therapeutic plasmapheresis (an evaluation of the efficacy of plasma substitute media and the methods for obtaining them)].

The analysis of 3700 plasmaphereses (AP) performed in 692 patients permitted the authors to develop the basic principles and policy of plasma substitution for various groups of patients. The use of protein preparations and fresh frozen plasma is believed essential in intensive plasmapheresis in patients with immunomediated disorders and DIC syndrome, respectively. Potentialities of selective therapeutic PA are discussed. PA criteria should be based on the patient's state, therapeutic aims, circulation parameters, laboratory data.

Blood Donors↗
PubMed1987

[Binding of drugs to artificial plasma substitutes].

The binding of different drugs to plasma proteins as well as the binding to other structures (e.g. dialysis membranes, i.v. delivery sets) is well documented and of therapeutic importance. Colloid solutions of macromolecules are widely used as plasma substitutes and plasma expanders. A possible binding of drugs to these macromolecules was investigated by means of equilibrium dialysis. Benzodiazepines, beta-blockers, cardiac glycosides, local anesthetics, non steroidal antiinflammatory drugs, glibenclamide, phenobarbitone and phenprocoumon (10(-7) in 50 mM tris buffer, pH 7.4) were dialyzed against tris buffer diluted (1:5) commercially available plasma substitutes consisting of hydroxyethyl starch (HES), dextran, gelatine and polyvinylpyrrolidone (PVP). Binding to plasma substitutes was observed with the highest values for penbutolol and oxypolygelatine (41%), digitoxin and HES 200 (35%), phenprocoumon and PVP (43%). It is concluded that the binding of drugs to plasma substitutes is in most cases negligible and not of clinical relevance. Since some drugs seem to bind to some extent to different macromolecules this should be borne in mind and could be of some influence e.g. in perfusion experiments with isolated organs.

Chemical Phenomena↗
PubMed1975

Plasma substitute induced impairment of the reticuloendothelial system function.

Currently used plasma substitutes are large colloids and are partly engulfed by reticuloendothelial (RE) cells. This study was designed to investigate the magnitude and duration of the possible RES dysfunction induced by plasma substitutes. The following substances were studied in both normal and burned (LD-10) CBA mice: allogen albumin 3%, and commercial preparations of dextran 40, dextran 70, hydroxyethyl starch, gelatin and PVP. Infusion volume was 20 ml/kg and i.v. infusion time 1 hour. Animals given allogen plasma served as controls. One, 3 and 6 hours after the i.v. injection of 51-Cr-rabbit RBC, we determined the disappearance rate, and uptake and distribution of the 51-Cr-RBC in the main RES organs (liver, spleen and lungs). In normal mice the disappearance rate was significantly decreased one and three hours post infusion, while it was decreased even after 6 hours in burned mice. Groups given albumin or plasma stayed close to non-infused animals. In order to clarify the physiologic significance of these findings we used another test substance known to be handled by the RES. Salmonella enteritidis endotoxin was tested with regard both to toxicity and rate of elimination. The toxicity, after i.p. injection, was significantly intensified both one and 3 hours post-infusion in normal mice. In burned mice toxicity became even more intense. The ability to eliminate 51-Cr-labelled endotoxin was significantly decreased following infusion in both normal and burned mice, one as well as three hours later. The in vitro liver phagocytosis was tested utilizing the liver slice technique. Standardized slices were incubated in Krebs-Ringer buffer together with 125-I-HSA aggregates as RES test substance with and without plasma from mice given plasma substitute infusions. Allogen plasma enhanced the phagocytic uptake (four times), while post-infusion plasma did not. It is concluded from these experiments, utilizing two different RES test substances in both normal and hypovolemic animals, that the plasma expanders tested do impair RES phagocytosis. The mechanism seems to be an interaction with phagocytosis-promoting plasma factors. Even though this impairment is temporary, it may jeopardize such important RES functions as elimination of microorganisms, toxins, cell debris and tumour cells, or spoil the afferent limb of the immune response to many antigens.

Animals↗
PubMed1979

[Effect of kidney function on the elimination and action of colloidal plasma substitutes].

Hypovolemia and prophylaxis of thrombosis are the main indications for colloidal plasma substitutes. This is also true for patients with renal failure. Due to their difference in molecular structure colloidal plasma substitutes, which are in clinical use--dextran, hydroxyethyl starch, gelatin--, are eliminated tbrough different pathways. However, the kidney plays an important role in the elimination of all three substances. Therefore pharmacokinetics and pharmacodynamics of colloidal plasma substitutes, which are based on dextran, hydroxyethyl starch and gelatin, were studied in patients with normal or impaired renal function. Renal insufficiency proved to affect the elimination and therapeutic efficacy of these colloids in different and characteristic ways. Consequently this requires special indications and dosage recommendations for patients with renal insufficiency.

Anuria↗
PubMed1979

[Effect of various plasma substitutes on blood groups].

In order to test the influence of the plasma substitutes Macrodex 6%, Plasmasteril and Expafusin on subsequent blood-typing and serologic tolerance tests, blood specimens of known donors of blood group 0 Rh negative were incubated with the respective plasma substitutes in various dilutions and serologic tests performed. In the AB0 and Rh system, none of the plasma substitutes tested caused falsely positive agglutinations. Reading of cross-match in the albumin test was not impeded in any of the substitutes. The higher molecular dextran Macrodex 6% and the high molecular hydroxyethylene starch Plasmateril appeared to have positive blood-group serologic reactions. With the low molecular hydroxyethylene starch Expafusin no irritations occurred in all tests of cross-matching.

ABO Blood-Group System↗
PubMed1978

[Indications and contraindications for plasma substitutes in surgery].

The indication for the infusion of plasma substitutes has been considerably limited as the result of a series of grave incidents. Prior to each application, differential-therapeutic deliberations must decide on the choice of plasma substitute bringing about the desired success in accordance with its physico-chemical characteristics and clinical values. The type and severity of a probable anaphylactoid incident and its therapy should also be considered.

Anaphylaxis↗
PubMed1991

[Anaphylactoid reaction to Physiogel SRK 4%--a contribution to the controversy about plasma substitutes].

Allergic reactions caused by colloid plasma substitutes are a well known complication in infusion therapy. The incidence of these adverse effects depends on the type of colloid used. Severe anaphylactic or anaphylactoid reactions are generally rare. Nevertheless, the risk of adverse allergic effects is an important aspect of the crystalloid-versus-colloid controversy. The exact pathophysiologic mechanisms remain as yet unclear; reliable prophylactic measures are not universally available. To draw attention to these problems we report a case of severe anaphylactoid reaction to Physiogel SRK.

Anaphylaxis↗
PubMed1989

The effect of iso-oncotic plasma substitutes: gelatine, dextran 40 (50 g/l) and the effect of Ringer's lactate on the plasma volume in healthy subjects.

82 healthy subjects undergoing Extra-corporeal Shock Wave Lithotripsy (ESWL) under epidural anesthesia were given 1000 ml of either gelatine (Geloplasme), dextran 40, 50 g/l (Isodex) or Ringer's lactate. The purpose of the study was to determine the efficacy of the three described solutions in respect to blood volume changes. A clear differentiation is only possible under absolutely defined physiological conditions and therefore in contrast to other studies, none of these patients was suffering from any shock syndrome or had any blood loss, so no capillary leakage or transcapillary refill problem was present. Plasma volume (PV), colloid oncotic pressure (COP) and hematocrit (Hct) were measured before and 15, 120 and 240 min. after infusion. PV increased both in the gelatine and dextran groups with a higher initial increase in the dextran group. COP increased after 15 min. and Hct decreased after 15 min. in the gelatine and dextran groups. With regard to absolute contraindications this study suggests that dextran 40 can be recommended as plasma substitute due to its higher initial increase in PV, its moderate duration of effect and its low incidence of anaphylactic reaction after a preceding infusion of 20 ml dextran Mw 1000 (Promiten).

Adult↗
PubMed1989

[Therapy of cerebral infarction by infusion of plasma substitutes].

In a total of 152 cases of severe cerebral infarction intravascular infusion of plasma substitutes was a part of combined therapy. Hemostasis studies in these patients allowed us to detect various degrees of hypercoagulation as a response to hemodilution. In cases of most pronounced post-hemodilution++ hypercoagulation (77 patients) complications, including those of thrombohemorrhagic nature, were increased in rate (74%) with more severe course of cerebral infarction. Of these 77 patients 46 died (59.7%). In 75 cases with no substantial hypercoagulation, the disease had a more benign course with 2 casulties (2.7%). The hemodilution tests should precede the therapeutic use of plasma substitutes in cerebral infarct patients.

Blood Coagulation Tests↗
PubMed1989

[An experimental study of the water balance and acid-base state of the blood during infusions of the plasma substitute oksiamal].

The influence of the plasma substitute oxyamal on shifts in the water and acid-base balance of the blood was studied in experiments on dogs with simulated severe hemorrhagic shock. Oxyamal therapy of the severe hemorrhagic shock led to a stable reduction of the volume of circulating plasma and blood, and to a rapid normalization of blood circulation. No disorders were observed in the fluid distribution in the body, acid-base balance rapidly recovered that has evidenced a full-value transcapillary water-ion exchange.

Acid-Base Equilibrium↗
PubMed1985

Three per cent dextran-60 as a plasma substitute in blood component therapy. I. An alternative in surgical blood loss replacement.

Microaggregate-poor erythrocyte concentrate with 3% dextran-60 as a plasma substitute was compared with microaggregate-poor whole blood for replacement of intra-operative and immediately postoperative blood loss. Sixty patients undergoing total hip arthroplasty randomly received either of these two forms of therapy. In accordance with the clinical routine of our orthopedic department, an infusion of 500 ml of 6% dextran-70 (Macrodex) was given as thrombo-prophylaxis in both groups. Use of 3% dextran-60 as a plasma substitute in blood component therapy for surgical hemorrhage of up to 50% of the calculated blood volume caused no increase in bleeding tendency or frequency of postoperative hematoma compared with whole blood replacement. Plasma protein levels were low immediately postoperatively in patients given the dextran, but from the 4th postoperative day onward there was no difference between the groups. Applied in clinical practice, this would be efficient in saving plasma for other urgent purposes.

Aged↗
PubMed1985

Three per cent dextran-60 as a plasma substitute in blood component therapy. II. Comparative studies on pre- and postoperative blood volume.

Microaggregate-poor erythrocyte concentrate with 3% dextran-60 as a plasma substitute was compared with microaggregate-poor whole blood for replacement of intra-operative blood loss. Their blood volume-conserving effects were studied by sequential blood volume determination with radioactive technetium (99mTc) in 19 patients undergoing total hip arthroplasty. Pre-operatively there was no difference in blood volume between the groups. Immediately after surgery and on the 2nd postoperative day there was no difference in total blood volume. Blood component therapy with 3% dextran as a plasma substitute is an efficient principle for intra-operative blood loss replacement at hip operations.

Aged↗
PubMed1975

[The effect of the plasma substitutes hydroxyethyl starch and dextrane-60 on the kidney function of dogs in acute haemorrhagic shock (author's transl)].

In 14 dogs during experimentally induced haemorrhagic shock the effects of 6% solutions of hydroxyethyl starch and Dextran-60 were compared. As main parameters of the renal function the arterial and venous pressures, renal blood flow, creatinine-clearance as measure of the glomerular filtration rate, urinary flow rate and urinary excretion of sodium and potassium were estimated. After complete substitution of the lost blood volume both plasma substitutes increased the renal blood flow by 50%. Glomerular filtration rate returned to control values, urinary volume and potassium output increased whereas sodium output decreased slightly. If only 50% of the lost volume was substituted, the renal blood flow and filtration rate remained at or below control values. Hydroxyethyl starch and Dextran-60 proved to be almost equally effective in restoring renal function.

Animals↗