Low-grade hemodilution improves the microcirculatory function in surgical patients
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
39740739
DOI
10.1016/j.mvr.2024.104781
PII: S0026-2862(24)00130-4
Knihovny.cz E-zdroje
- Klíčová slova
- Crystalloid fluid, Microvessel density, Pharmacokinetics, Plasma dilution,
- MeSH
- časové faktory MeSH
- dospělí MeSH
- hemodiluce * metody škodlivé účinky MeSH
- kapilární permeabilita MeSH
- kinetika MeSH
- krystaloidní roztoky aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrocirkulace * MeSH
- regionální krevní průtok MeSH
- retrospektivní studie MeSH
- senioři MeSH
- ústní sliznice * krevní zásobení MeSH
- ústní spodina * krevní zásobení MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- krystaloidní roztoky MeSH
BACKGROUND: Excess fluid in the interstitium can adversely affect the microcirculation. We studied how gradual dilution of the blood plasma by crystalloid fluid influences microcirculatory variables and capillary filtration in 20 patients undergoing surgery. METHODS: Video recordings of the sublingual mucosal were made on four occasions during the surgery and compared with quasi-measurements of the capillary filtration rate using retrospective volume kinetic data collected over 5-10-minute periods during 262 infusion experiments with crystalloid fluid. RESULTS: The number of crossings (vessel density) increased up to plasma dilution of 15-20 % whereafter it decreased. The proportion of the vessels that were perfused (PPV) decreased and reached a nadir of -15 % at a dilution of 20-30 %. Changes in the number of crossings and the PPV correlated (r = 0.62, P < 0.001) but the curve was displaced so that crossings showed no change when PPV had decreased by approximately 10 %. However, the PPV of vessels with a thickness of ≤25 μm increased or remained constant in the dilution range of up to 20 %. The volume kinetic analysis showed that the capillary filtration was greater than expected from proportionality with the volume expansion up to a plasma dilution of 15 %, the greatest difference (+89 %) being for plasma dilution up to 5 %. CONCLUSION: Plasma dilution of up to 15 % increased the vessel density, and the capillary filtration increased by more than suggested by the volume expansion. Dilution >15 % had a negative influence on these variables.
Dept of Surgery University Hospital Hradec Kralove Czech Republic
Faculty of Medicine Hradec Kralove Charles University Czech Republic
Karolinska Institutet at Danderyds Hospital Stockholm Sweden
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