[Exact measurement of the volume effect of 6% hydoxyethyl starch 130/0.4 (Voluven) during acute preoperative normovolemic hemodilution].

Background: What is the effect of preoperative acute normovolemic hemodilution (ANH) with 6% hydroxyethyl starch (HES) 130/0.4 (Voluven) on blood volume?

Methods: In 10 patients undergoing radical hysterectomy, ANH was performed to a hematocrit of 21% using 6% HES 130/0.4 (Voluven) whereby a replacement of blood with 115% of colloid was planned.

Changes in blood volume and hematocrit during acute preoperative volume loading with 5% albumin or 6% hetastarch solutions in patients before radical hysterectomy.

Background: The impact of acute preoperative volume loading with colloids on blood volume has not been investigated sufficiently.

Methods: Before surgery, in 20 patients undergoing major gynecologic procedures, volume loading was performed during anesthesia by infusing approximately 20 ml/kg of colloid at a rate of 90 ml/min (group I: 5% albumin solution; group II: 6% hetastarch solution; n = 10 each). Plasma volume (indocyanine green dilution technique), erythrocyte volume (labeling erythrocytes with fluorescein), hematocrit, total protein, and hetastarch plasma concentrations (group II) were measured before and 30 min after the end of infusion.

[Acute "normovolemic" hemodilution with 3.5% polygel (Haemaccel) for patients in the Wertheim-Meigs-operation. Blood loss of 87% blood volume without perioperative blood transfusion].

Question: Is polygeline (Haemaccel) a suitable colloid to perform preoperative acute normovolemic hemodilution (ANH) and to replace a large intraoperative blood loss?

Methods: In a sixty-eight-year-old patient undergoing radical hysterectomy preoperative ANH was performed to a hematocrit of 23% using 3.5% polygeline (Haemaccel). Intraoperative retransfusion of ANH blood was started at a hematocrit of 13%.

[Changes in blood volume during acute normovolemic hemodilution with 5% albumin or 6% hydroxyethylstarch and intraoperative retransfusion].

Question: What is the impact of acute preoperative normovolemic hemodilution (ANH) on blood volume, intravascular colloid, and loss of red cells in the perioperative period?

Methods: In 20 patients undergoing radical hysterectomy, preoperative ANH was performed to a hematocrit of 22% using 5% albumin (albumin group; n = 10) or 6% hydroxyethylstarch solution (HES group; n = 10). Intraoperative retransfusion of ANH blood was started at a hematocrit of 18%. Plasma volume (indocyanine green-dilution technique), hematocrit, and plasma protein concentration were measured before and after ANH, before retransfusion, and postoperatively.

Acid-base changes caused by 5% albumin versus 6% hydroxyethyl starch solution in patients undergoing acute normovolemic hemodilution: a randomized prospective study.

Background: Preoperative acute normovolemic hemodilution (ANH) is an excellent model for evaluating the effects of different colloid solutions that are free of bicarbonate but have large chloride concentrations on acid-base equilibrium.

Methods: In 20 patients undergoing gynecologic surgery, ANH to a hematocrit of 22% was performed. Two groups of 10 patients each were randomly assigned to receive either 5% albumin or 6% hydroxyethyl starch solutions containing chloride concentrations of 150 and 154 mm, respectively, during ANH.

Changes in intravascular volume during acute normovolemic hemodilution and intraoperative retransfusion in patients with radical hysterectomy.

Background: Changes in blood volume during acute normovolemic hemodilution (ANH) and their consequences for the perioperative period have not been investigated sufficiently.

Methods: In 15 patients undergoing radical hysterectomy, preoperative ANH to a hematocrit of 24% was performed using 5% albumin solution. Intraoperatively, saline 0.

First clinical implications of perioperative red cell volume measurement with a nonradioactive marker (sodium fluorescein).

Unlabelled: We measured red cell volume (RCV) with the nonradioactive marker sodium fluorescein (SoF) in 30 patients undergoing gynecological operations. Sixteen patients underwent preoperative isovolemic hemodilution (PIHD). RCV measurements were performed before and after PIHD and at the end of the operation.

Extra protein loss not caused by surgical bleeding in patients with ovarian cancer.

Background: [corrected] Clinical experience in patients with ovarian cancer has shown special difficulties in maintaining cardiovascular stability during surgery.

Methods: To evaluate the causes for this observation, 15 patients with benign ovarian tumours (group I) and 13 patients with ovarian cancer (group II) were investigated perioperatively. Plasma volume (indocyanine green-dilution technique), haematocrit, plasma protein concentration, mean arterial pressure, heart rate, and central venous pressure were measured immediately before and after cytoreductive surgery.

Isovolemic hemodilution alters the ratio of whole-body to large-vessel hematocrit (F-cell ratio). A prospective, randomized study comparing the volume effects of hydroxyethyl starch 200,000/0.62 and albumin.

Objective: To evaluate potential changes in the ratio of whole-body/large-vessel hematocrit (f-cell ratio) during isovolemic hemodilution and to compare the volume effects of 2 different plasma exchange solutions (hydroxyethyl starch 200,000/0.62 6% and human albumin 5%).

Design: Prospective, randomized, controlled trial.

Determination of plasma volume with indocyanine green in man.

We investigated the feasibility of using indocyanine green (ICG) for plasma volume (PV) determination in man. Duplicate PV measurements were carried out in 23 healthy subjects to test repeatability. ICG (0.

Blood sample analysis and monitoring of hemodynamic parameters and renal function in the conscious rat.

A method is described for chronic instrumentation of the rat with arterial and venous catheters. The technique minimizes the risk of catheter occlusion and damage, and reduces restraint of the animals during the evaluation. In the conscious animal, hemodynamic parameters and renal function can be monitored while substances are injected or blood samples withdrawn.

[The determination of plasma volume using indocyanine green in man].

The importance of circulating blood (BV) and plasma volume (PV) in critically ill patients and physiological research is unchallenged. Recently, Evans blue (EB) [8, 25] and radioactively labelled serum albumin (RIHSA) [20] have mostly been used as tracers for PV determination. However, the disadvantages of radioactive contamination (RIHSA) and dye accumulation (EB), especially in repeated measurements, are obvious.

PGE2 concentrations in renal venous plasma and renal lymph during basal and stimulated conditions in the dog.

PGE2 concentration (pg/ml + SEM) was measured in canine renal lymph (394 +/- 115), renal venous plasma (276 +/- 55), arterial plasma (172 +/- 34) and urine (1290 +/- 934). Control periods were followed by an infusion of the sodium salt of arachidonic acid (AA) (40 micrograms/kg min) into the renal artery to stimulate prostaglandin synthesis. During infusion of AA PGE2 concentrations increased significantly in renal lymph (672 +/- 155) renal venous plasma (549 +/- 123), and urine (6768 +/- 1420), but not in the arterial plasma (176 +/- 31).

A new technique for the cannulation of small lymph vessels.

A method is described which allows rapid cannulation of small lymph vessels using a modified, in-dwelling cannula and a tissue glue. The method was used to cannulate hilar lymph vessels of the kidney but should but appropriate to cannulate small lymph vessels at other locations as well.

[Determination of plasma volume with indocyanine green].

In 31 anesthetized dogs, the distribution volume (Vd) of indocyanine green (ICG, Cardiogreen) was compared to that of Evans blue (EB), which is considered to represent plasma volume. Vd was computed from the injected amount of indicator and the indicator concentration in plasma at time zero, which was obtained by extrapolation of the monoexponential decay of the indicator concentration. The decay was assessed by eight plasma samples from 10-60 min and from 5-12 min after injection of EB and ICG, respectively.

Renin-angiotensin system responses of acute graded hemorrhage in dogs.

The effect of acute hemorrhage on hemodynamics and the renin-angiotensin system (RAS) was studied in eight anesthetized dogs. Stepwise blood loss to 17 +/- 6.2 ml/kg within 9 to 33 min decreased cardiac output (CO) to 42.

[Effect of ganglionic blockade and subsequent i.v. infusion of catecholamines and angiotensin II on the formation and transport of lymph. Studies in anesthesized dogs and a review of the literature].

The effect of ganglionic blockade (GB) and subsequent i.v. infusion of adrenaline (AD), noradrenaline (NA), isoproterenol (IP), and angiotensin II (AII) on thoracic duct lymph flow (LF) and transcapillary escape rate of plasma proteins (FER) was studied in anaesthetized (Nembutal), paralyzed (pancuronium), and artificially ventilated dogs.

[Effect of hyperoncotic volume administration on capillary protein filtration and lymph flow in the thoracic duct].

The effect of an intravenous injection (2 ml/kg) of hyperoncotic (30 g%) Dextran (MW 60000) or Albumin on lymph formation and thoracic duct lymph flow was studied in 16 dogs. As a result of the injection, plasma colloid osmotic pressure increased, plasma volume increased due to fluid reabsorption from the extravascular compartment, and thus cardiac output became enhanced. Total body lymph formation was not affected as shown by an unchanged transcapillary disappearance rate of macromolecules.

The influence of chronic subcutaneous nicotine administration on aldosterone and corticosterone plasma concentrations and the plasma renin activity.

Since adrenocortical hormones and the renin-angiotensin system are capable of inducing defined pathophysiologic changes in the cardiovascular system, similar to those observed after nicotine, experiments were performed in rats to investigate the effect of chronic nicotine administration on the plasma concentrations of aldosterone (PAC) and corticosterone (PCC) and on the plasma renin activity (PRA). The administration of nicotine (0.5 or 1.

Effects of nicotine on epithelial nephron cells in culture.

Long-term effects of nicotine on cultured cells derived from defined segments of the nephron were studied in vitro. Nicotine was added during a 10-day incubation period to a defined nephron culture medium (NCM) which had been supplemented with one of the following: fetal calf serum (FCS), dexamethasone (D), aldosterone (A), or epidermal growth factor (EGF). Thymidine incorporation (10(-15) mmol/10(3) cells) into cultured cells of the cortical thick ascending loop of Henle (TAL) and of the cortical collecting tubule (CT) was inhibited by nicotine (5 X 10(1) ng/ml) when incubated in NCM only; the presence of FCS or of D (10(-8) M) or of D and EGF (25 ng/ml) prevented this inhibitory effect.

[A time-saving empirical method to calculate the area under dye dilution curves for the determination of cardiac output (author's transl)].

A simple and time-saving method is given for calculation of the area under dye dilution curves. The analysis of 415 dye dilution curves had shown that the area (A) under the curve, corrected for recirculation by semilogarithmic extrapolation and integrated by planimetry, could be approximated by the product of the concentration peak height (H) and the distance (t75) between the time of indicator appearance and the time of decay of indicator concentration to 75% of peak concentration: A = H.t75.