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Objectives: To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9% NaCl in a rat sepsis model and to compare the plasma-expanding effect among these fluids., Design: Prospective, randomized animal study., Setting: University hospital laboratory., Subjects: One hundred and twelve adult male rats., Interventions: Sepsis was induced by cecal ligation and incision followed by closure of the abdomen. After 3 hrs, an infusion of the PV expander under study was started at a volume of 12mL/kg for the colloids and of 48mL/kg for 0.9% NaCl, either for 15 mins or for 3 hrs. A control group underwent the same experimental procedure but no fluid was given., Measurements and Main Results: Three hours after start of the infusion (end of experiment), the plasma-expanding effect was better with a slow than a fast infusion rate for the colloids, especially albumin, but the NaCl groups did not differ significantly from the control group. The PV for the control group was 28.7±3mL/kg. In the slow and the fast infusion groups, it was 38.9±4.3 and 32.6±4.2mL/kg for albumin (p < 0.001), 32.9±4.3 and 29.5±4.4mL/kg for hydroxyethyl starch 130/0.4 (p < 0.05), 31.8±3.9 and 28.2±4.1mL/kg for gelatin (p < 0.05), and 31.8±5.3 and 30.7±6.6mL/kg for NaCl (n.s), respectively., Conclusions: The study showed that the PV expansion by a colloid was greater when given at a slow than at a fast infusion rate, an effect more pronounced for albumin. This difference was not seen for NaCl. The PV-expanding effect was poor for NaCl and better for albumin than for the other colloids.

Background: We still lack comparing data of the plasma volume (PV)-expanding effect of the most commonly used colloids including dextran 70. This study compares the PV-expanding effects of 6% dextran 70, 5% albumin, and 6% hydroxyethylstarch (HES) 130/0.4 after a standardized hemorrhage., Methods: The prospective and randomized study on 33 anesthetized adult male guinea pigs involved three groups (n = 11 each); the dextran group, the albumin group, and the HES group. The left carotis artery was cannulated for blood pressure measurements and blood samples, and the right jugular vein was cannulated for infusions. After hemorrhage of 20 mL/kg for 8 minutes, the animals were transfused with 20 mL/kg of the colloid for 10 minutes. PV was determined with a I-albumin tracer dilution technique at baseline and 3 hours after the colloid infusion. The PV just after hemorrhage was calculated as the baseline value minus bled PV. Blood gases were measured at baseline, after hemorrhage, just after the colloid infusion and at the end of the experiment., Results: The increase in PV 3 hours after the colloid infusion, including the 20 mL infused, was 36.3 mL/kg +/- 2.3 mL/kg in the dextran group, 26.4 mL/kg +/- 4.7 mL/kg in the albumin group, and 17.6 mL/kg +/- 3.5 mL/kg in the HES group. At the end of the experiment, hematocrit was lower in the dextran group than in the albumin and the HES groups. Urine production was higher in the HES group than in the dextran and the albumin groups., Conclusion: After hemorrhage, the PV-expanding capacity of 6% dextran 70 was better than that of 5% albumin, which was in turn better than that of HES 130/0.4 given in equal volumes.

Objective: To compare the colloids 5% albumin, 4% gelatin, and 6% HES 130/0.4 with one another and with normal saline regarding their plasma expanding effects at increased permeability and to compare the results with those from a previous study at normal permeability., Design and Setting: Prospective controlled randomized laboratory study in a university research laboratory., Subjects: 48 adult male Sprague-Dawley rats., Interventions: Permeability was increased by an injection of 0.5 ml dextran 70 using the fact that dextran causes anaphylactic reaction in the rat. Plasma volume was determined ((125)I albumin tracer technique) after anesthesia, 1 h after dextran injection (before infusion for 10-15 min of 20 ml/kg bw of each of the colloids or 80 ml/kg saline), and 3 h later. Blood pressure, hematocrit, blood gases, and electrolytes were measured. CVP was measured in four rats., Measurements and Results: Plasma volume was 41.1+/-1.9 ml/kg at baseline (n=9), and 29.1+/-4.1 ml/kg (n=35) 1 h after the dextran injection. Three hours after infusion of the plasma expander plasma volume had increased by 17.1+/-3.4 ml/kg in the albumin group, 7.9+/-3.6 ml/kg in the gelatin group, 7.4+/-4.4 ml/kg in the HES group, and 12.2+/-3.1 ml/kg in the saline group. It was unchanged in a control group given no solution (n=7 for all groups)., Conclusion: Albumin was a more effective plasma volume expander than gelatin or HES or saline (saline in 4 times larger volume). Gelatin and HES were equally effective. All solutions showed a smaller plasma expanding effect than observed in a previous study with normal permeability.

Objective: To compare the colloids 5% albumin, 4% gelatin and 6% hydroxyethyl starch (HES) 130/0.4 with each other and with saline, regarding their plasma-expanding effects after haemorrhage; these were also compared with the intravascular volume-expanding effect of re-transfusion with erythrocytes., Design: Controlled, prospective, randomised laboratory study., Setting: University research laboratory., Subjects: Thirty-five adult rats., Interventions: Plasma volume was determined (I(125) albumin tracer technique) after haemorrhage of 20 ml/kg and 3 h after a bolus infusion of 20 ml/kg of each of the colloids or 80 ml/kg of saline, or 6.7 ml/kg of erythrocytes diluted in 9 ml/kg of saline. Blood pressure, haematocrit (Hct), blood gases and physiological parameters were measured., Measurements and Results: Plasma volume after haemorrhage was 29.6+/-2.6 ml/kg (n=35). With the bolus infusion, plasma volume increased by 21.1+/-3.6 ml/kg in the albumin group (n=7), by 13.1+/-2.9 ml/kg in the gelatin group (n=7), by 13.8+/-2.2 ml/kg in the HES group (n=7), by 16.0+/-2.4 ml/kg in the saline group (n=7) and by 6.9+/-2.3 ml/kg in the erythrocyte group (n=7) 3 h after the infusion. In the latter group, there was a total increase in intravascular volume of 13.6+/-2.5 ml/kg including the erythrocyte volume. Arterial pressure was better preserved in the albumin and erythrocyte groups than in the other groups., Conclusion: Albumin 5% was a more effective plasma volume expander than gelatin and HES. Saline, with a four times larger volume, and erythrocytes in about 1/3 of the volume had a similar volume-expanding effect to gelatin and HES.