The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs

Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Pape, Andreas [verfasserIn] Kutschker, Saskia Kertscho, Harry Stein, Peter Horn, Oliver Lossen, Mischa Zwissler, Bernhard Habler, Oliver

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2012

Schlagwörter:	Mean Arterial Pressure Stroke Volume Variation Stroke Volume Index Plasma Viscosity Circulate Blood Volume

Anmerkung:	© Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (

Übergeordnetes Werk:	Enthalten in: Critical care - London : BioMed Central, 1997, 16(2012), 2 vom: 30. Apr.
Übergeordnetes Werk:	volume:16 ; year:2012 ; number:2 ; day:30 ; month:04

Links:	Volltext

DOI / URN:	10.1186/cc11324

Katalog-ID:	SPR029841607

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520			\|a Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function.
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author_variant	a p ap s k sk h k hk p s ps o h oh m l ml b z bz o h oh
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allfields	10.1186/cc11324 doi (DE-627)SPR029841607 (SPR)cc11324-e DE-627 ger DE-627 rakwb eng Pape, Andreas verfasserin aut The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. Mean Arterial Pressure (dpeaa)DE-He213 Stroke Volume Variation (dpeaa)DE-He213 Stroke Volume Index (dpeaa)DE-He213 Plasma Viscosity (dpeaa)DE-He213 Circulate Blood Volume (dpeaa)DE-He213 Kutschker, Saskia aut Kertscho, Harry aut Stein, Peter aut Horn, Oliver aut Lossen, Mischa aut Zwissler, Bernhard aut Habler, Oliver aut Enthalten in Critical care London : BioMed Central, 1997 16(2012), 2 vom: 30. Apr. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:16 year:2012 number:2 day:30 month:04 https://dx.doi.org/10.1186/cc11324 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2012 2 30 04
spelling	10.1186/cc11324 doi (DE-627)SPR029841607 (SPR)cc11324-e DE-627 ger DE-627 rakwb eng Pape, Andreas verfasserin aut The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. Mean Arterial Pressure (dpeaa)DE-He213 Stroke Volume Variation (dpeaa)DE-He213 Stroke Volume Index (dpeaa)DE-He213 Plasma Viscosity (dpeaa)DE-He213 Circulate Blood Volume (dpeaa)DE-He213 Kutschker, Saskia aut Kertscho, Harry aut Stein, Peter aut Horn, Oliver aut Lossen, Mischa aut Zwissler, Bernhard aut Habler, Oliver aut Enthalten in Critical care London : BioMed Central, 1997 16(2012), 2 vom: 30. Apr. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:16 year:2012 number:2 day:30 month:04 https://dx.doi.org/10.1186/cc11324 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2012 2 30 04
allfields_unstemmed	10.1186/cc11324 doi (DE-627)SPR029841607 (SPR)cc11324-e DE-627 ger DE-627 rakwb eng Pape, Andreas verfasserin aut The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. Mean Arterial Pressure (dpeaa)DE-He213 Stroke Volume Variation (dpeaa)DE-He213 Stroke Volume Index (dpeaa)DE-He213 Plasma Viscosity (dpeaa)DE-He213 Circulate Blood Volume (dpeaa)DE-He213 Kutschker, Saskia aut Kertscho, Harry aut Stein, Peter aut Horn, Oliver aut Lossen, Mischa aut Zwissler, Bernhard aut Habler, Oliver aut Enthalten in Critical care London : BioMed Central, 1997 16(2012), 2 vom: 30. Apr. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:16 year:2012 number:2 day:30 month:04 https://dx.doi.org/10.1186/cc11324 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2012 2 30 04
allfieldsGer	10.1186/cc11324 doi (DE-627)SPR029841607 (SPR)cc11324-e DE-627 ger DE-627 rakwb eng Pape, Andreas verfasserin aut The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. Mean Arterial Pressure (dpeaa)DE-He213 Stroke Volume Variation (dpeaa)DE-He213 Stroke Volume Index (dpeaa)DE-He213 Plasma Viscosity (dpeaa)DE-He213 Circulate Blood Volume (dpeaa)DE-He213 Kutschker, Saskia aut Kertscho, Harry aut Stein, Peter aut Horn, Oliver aut Lossen, Mischa aut Zwissler, Bernhard aut Habler, Oliver aut Enthalten in Critical care London : BioMed Central, 1997 16(2012), 2 vom: 30. Apr. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:16 year:2012 number:2 day:30 month:04 https://dx.doi.org/10.1186/cc11324 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2012 2 30 04
allfieldsSound	10.1186/cc11324 doi (DE-627)SPR029841607 (SPR)cc11324-e DE-627 ger DE-627 rakwb eng Pape, Andreas verfasserin aut The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs 2012 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. Mean Arterial Pressure (dpeaa)DE-He213 Stroke Volume Variation (dpeaa)DE-He213 Stroke Volume Index (dpeaa)DE-He213 Plasma Viscosity (dpeaa)DE-He213 Circulate Blood Volume (dpeaa)DE-He213 Kutschker, Saskia aut Kertscho, Harry aut Stein, Peter aut Horn, Oliver aut Lossen, Mischa aut Zwissler, Bernhard aut Habler, Oliver aut Enthalten in Critical care London : BioMed Central, 1997 16(2012), 2 vom: 30. Apr. (DE-627)331258269 (DE-600)2051256-9 1364-8535 nnns volume:16 year:2012 number:2 day:30 month:04 https://dx.doi.org/10.1186/cc11324 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2012 2 30 04
language	English
source	Enthalten in Critical care 16(2012), 2 vom: 30. Apr. volume:16 year:2012 number:2 day:30 month:04
sourceStr	Enthalten in Critical care 16(2012), 2 vom: 30. Apr. volume:16 year:2012 number:2 day:30 month:04
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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. 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author	Pape, Andreas
spellingShingle	Pape, Andreas misc Mean Arterial Pressure misc Stroke Volume Variation misc Stroke Volume Index misc Plasma Viscosity misc Circulate Blood Volume The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs
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topic_title	The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs Mean Arterial Pressure (dpeaa)DE-He213 Stroke Volume Variation (dpeaa)DE-He213 Stroke Volume Index (dpeaa)DE-He213 Plasma Viscosity (dpeaa)DE-He213 Circulate Blood Volume (dpeaa)DE-He213
topic	misc Mean Arterial Pressure misc Stroke Volume Variation misc Stroke Volume Index misc Plasma Viscosity misc Circulate Blood Volume
topic_unstemmed	misc Mean Arterial Pressure misc Stroke Volume Variation misc Stroke Volume Index misc Plasma Viscosity misc Circulate Blood Volume
topic_browse	misc Mean Arterial Pressure misc Stroke Volume Variation misc Stroke Volume Index misc Plasma Viscosity misc Circulate Blood Volume
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title	The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs
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title_full	The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs
author_sort	Pape, Andreas
journal	Critical care
journalStr	Critical care
lang_code	eng
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author_browse	Pape, Andreas Kutschker, Saskia Kertscho, Harry Stein, Peter Horn, Oliver Lossen, Mischa Zwissler, Bernhard Habler, Oliver
container_volume	16
format_se	Elektronische Aufsätze
author-letter	Pape, Andreas
doi_str_mv	10.1186/cc11324
title_sort	choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs
title_auth	The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs
abstract	Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (
abstractGer	Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (
abstract_unstemmed	Introduction The correction of hypovolemia with acellular fluids results in acute normovolemic anemia. Whether the choice of the infusion fluid has an impact on the maintenance of oxygen ($ O_{2} $) supply during acute normovolemic anemia has not been investigated so far. Methods Thirty-six anesthetized and mechanically ventilated pigs were hemodiluted to their physiological limit of anemia tolerance, reflected by the individual critical hemoglobin concentration ($ Hb_{crit} $). $ Hb_{crit} $ was defined as the Hb-concentration corresponding with the onset of supply-dependency of total body $ O_{2} $-consumption ($ VO_{2} $). The hemodilution protocol was randomly performed with either tetrastarch (6% HES 130/0.4, TS-group, n = 9), gelatin (3.5% urea-crosslinked polygeline, GEL-group, n = 9), hetastarch (6% HES 450/0.7, HS-group, n = 9) or Ringer's solution (RS-group, n = 9). The primary endpoint was the dimension of $ Hb_{crit} $, secondary endpoints were parameters of central hemodynamics, $ O_{2} $ transport and tissue oxygenation. Results In each animal, normovolemia was maintained throughout the protocol. $ Hb_{crit} $ was met at 3.7 ± 0.6 g/dl (RS), 3.0 ± 0.6 g/dl (HS P < 0.05 vs. RS), 2.7 ± 0.6 g/dl (GEL, P < 0.05 vs. RS) and 2.1 ± 0.4 g/dl (TS, P < 0.05 vs. GEL, HS and RS). Hemodilution with RS resulted in a significant increase of extravascular lung water index (EVLWI) and a decrease of arterial oxygen partial pressure ($ paO_{2} $), and $ O_{2} $ extraction ratio was increased, when animals of the TS-, GEL- and HS-groups met their individual $ Hb_{crit} $. Conclusions The choice of the intravenous fluid has an impact on the tolerance of acute normovolemic anemia induced by acellular volume replacement. Third-generation tetrastarch preparations (e.g., HES 130/0.4) appear most advantageous regarding maintenance of tissue oxygenation during progressive anemia. The underlying mechanism includes a lower degree of extravasation and favourable effects on microcirculatory function. © Pape et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (
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title_short	The choice of the intravenous fluid influences the tolerance of acute normovolemic anemia in anesthetized domestic pigs
url	https://dx.doi.org/10.1186/cc11324
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author2	Kutschker, Saskia Kertscho, Harry Stein, Peter Horn, Oliver Lossen, Mischa Zwissler, Bernhard Habler, Oliver
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