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  • 1
    Electronic Resource
    Electronic Resource
    Oxford UK : Blackwell Science Ltd
    Pediatric anesthesia 11 (2001), S. 0 
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Methods: Acid–base, electrolyte and metabolite concentrations were determined in 100 U of packed red blood cells (RBC) preserved in extended-storage media to be used for major transfusion in paediatric and cardiac surgery. Results: In fresh RBC, low pH, bicarbonate (cHCO3−), base excess (BE) and high glucose values were observed all outside the physiological range. With lengthening storage duration, values of pH, cHCO3−, BE, sodium and glucose decreased and carbon dioxide, potassium and lactic acid concentrations increased [mean ± SD (range): storage duration 6.7 ± 3.8 (1–17) days, pH 6.79 ± 0.1 (6.53–6.99); mmol·l–1: cHCO3− 11.1 ± 1.5 (6.2–14.5), BE − 29.2 ± 4.1 ([−39.4] − [−20.9]), potassium 20.5 ± 7.8 (4.2–43.6), glucose 24.1 ± 6.1 (16.7–29.2), lactic acid 9.4 ± 4 (4.3–21.4)]. Conclusions: Massive and rapid transfusion of RBC may lead to a severe burden of hydrogen ions, carbon dioxide, potassium, glucose and lactic acid and this can be avoided by cell saver blood processing, when autologous erythrocytes from the operative field are saved and substrate load and storage lesions from packed red blood cells are minimized in one step by washing.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We investigated haemodynamic, acid–base and electrolyte changes during almost total plasma replacement with hydroxyethyl starch (HES) and physiological balanced electrolyte solution (PBE) by using a cell saver in ten young pigs. In the PBE group an additional 3550 (444) ml crystalloid solution [Mean (SD)] was infused over the course of the study in order to maintain pulmonary capillary wedge pressure. Plasma protein levels decreased in both groups and the colloid osmotic pressure increased in HES and decreased in PBE. At the end of the study, body weight [HES 10.4 (1), PBE 13.1 (1.4) kg, P 〈 0.01] and lactic acid concentration [HES 0.9 (0.3), PBE 2.9 (1.3) mmol.l −1, P 〈 0.01] was higher and tissue oxygen delivery [HES 327 (22), PBE 89 (29) ml.min·m2, P 〈 0.01] was lower in the PBE group. There were only moderate acid–base changes in both groups, but at the end, anion gap was significant lower in HES. In conclusion, maintenance of colloid osmotic pressure close to the physiological range of infants seems to be advantageous during major paediatric surgery.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Key words Hydroxyethyl starch ; Modified fluid gelatin ; Chloride ; Anion gap ; Acid base ; Saline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In ten piglets (body weight 8.2–11.6 kg), acid base, electrolyte and anion gap changes were investigated during almost total plasma replacement with hydroxyethyl starch (HES) and modified fluid gelatin (GEL) in saline solution using a cell saver autotransfusion technique. During the study, there were only moderate acid base changes, but marked disturbances in anion balance. At study end, the mean chloride concentration was significantly higher (mmol/l: normal values 97–108, HES 116 ± 1.5, GEL 108 ± 1.1, p 〈 0.01) and the mean anion gap was significantly lower in the HES group in comparison to the GEL group (mmol/l: normal values 5–14, HES 3 ± 1.7, GEL 11.9 ± 0.9, p 〈 0.01). It is concluded that plasma replacement with electroneutral HES, but not with negatively charged GEL, can lower the anion gap irrespective of the underlying disease. This can be misleading when the anion gap is used for differential diagnosis of metabolic acidosis in patients after large volume infusion of synthetic colloids.
    Type of Medium: Electronic Resource
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