BACKGROUND: Various plasma substitutes are used for the correction of hypovolemia caused by blood loss. It is known that plasma substitutes themselves have some adverse effects on blood coagulation. We performed this study to show the actual effect of plasma substitutes on blood coagulation in clinical hypovolemic situation caused by blood loss. METHODS: 60 patients scheduled for radical hysterectomy were grouped by the plasma substitutes infused; group C, S, V and P correspondingly infused with Hartman's solution, Salinhes(R), Voluven(R) and Pentaspan(R). Thromboelastograms (TEG) at 15 minutes after induction of anesthesia (T(0)), after 15% blood loss of the estimated blood volume (T(1)) and just after infusion of the plasma substitutes (T(2)) were compared among the groups and changes with the time course within each group were investigated. RESULTS: Compared to group C, MA, A60, coagulation index, CL60 (parameters of TEG) were decreased and LY60 increased in group S and P while group V presented no significant changes. Hypercoagulability and reduced fibrinolysis were observed for T(1); for T(2), group C showed decrease in k-time, LY60 and increase in alpha angle, CL60. Group S presented decrease in MA, A60 compared to T0 and decrease in CL60 and increase in LY60. CONCLUSIONS: Surgery and blood loss accelerated coagulation and reduced fibrinolysis. These were aggravated after crystalloid infusion. In contrast, coagulability was reduced and fibrinolysis augmented after infusion of HES except HES 130/0.4/6.
Anesthesia ; Blood Coagulation ; Blood Volume ; Fibrinolysis ; Humans ; Hypovolemia ; Hysterectomy* ; Plasma Substitutes* ; Plasma* ; Thrombophilia

PURPOSE: The objective of the present study is to investigate the steady and pulsatile flow phenomena of the blood substitute fluids in the circular and bifurcated vessels numerically and experimentally. METHODS: The particle image velocimetry (PIV) is adopted to visualize the flow fields in the circular and bifurcated vessels. In order to analyse the complex flow phenomena of the blood substitute fluids in the bifurcated vessel, the constitutive equations which are suitable to describe the rheological properties of the non-Newtonian fluids are determined and the steady and unsteady momentum equations are solved by the finite volume prediction. RESULTS AND CONCLUSION: Velocity vectors of the steady flow in the bifurcated tube obtained by the PIV system are in good agreement with those obtained by the numerical analysis. The experimental and numerical results show the recirculation zone in the outer wall distal to bifurcation.
Blood Substitutes* ; Pulsatile Flow* ; Rheology*

OBJECTIVETo determine the combined effect of hypothermia and crystalloid hemodilution on blood solubility of volatile anesthetics.

METHODSTwo hundred and thirty ml blood samples obtained from each of twelve healthy male volunteers were adjusted to a hematocrit of 40% and then diluted with normal saline to hematocrits of 36%, 32%, 28%, 24%, and 20%. Blood/gas partition coefficients of desflurane, sevoflurane, isoflurane, enflurane and halothane were measured at 37 degrees C,33 degrees C, 29 degrees C, 25 degrees C, 21 degrees C and 17 degrees C using a two-stage headspace double equilibration method.

RESULTSAs the temperature decreased, the logarithm of the blood/gas partition coefficient increased linearly (P < 0.05). As the hematocrit decreased, the logarithm of the blood/gas partition coefficient decreased linearly (P < 0.05). The combined effect of hypothermia and crystalloid hemodilution on blood solubility of anesthetics was expressed by multiple linear regression equations as follows: Desflurane: log(e)lambda(B/G)=-0.0302 x T+0.0094 x HCT+0.119 R(2)=0.973. Sevoflurane: log(e)lambda(B/G)=-0.0295 x T+0.0092 x HCT+0.306 R(2)=0.961. Isoflurane: log(e)lambda(B/G)=-0.0382 x T+0.0154 x HCT+1.120 R(2)=0.997. Enflurane: log(e)lambda(B/G)=-0.0408 x T+0.0198 x HCT+1.408 R(2)=0.982. Halothane: log(e)lambda(B/G)=-0.0417 x T+0.0218 x HCT+1.649 R(2)=0.994. Where lambda(B/G) is the blood/gas partition coefficient, T is temperature (degrees C) and HCT is hematocrit (%).

CONCLUSIONSHypothermia increases, while crystalloid hemodilution decreases the blood solubility of volatile anesthetics. The combined effect of hypothermia and hemodilution on blood solubility at any cross point of temperature from 37 degrees C to 17 degrees C and hematocrit from 40% to 20% could be predicted by the multiple linear regression equations developed in this study.

Adult ; Anesthetics, Inhalation ; blood ; chemistry ; Cold Temperature ; Hematocrit ; Hemodilution ; Humans ; Hypothermia, Induced ; Isotonic Solutions ; Male ; Plasma Substitutes ; Solubility

AIMTo observe effect of acute normovolemic hemodilution(ANH) with HAES-balanced solution as diluting agent on levels of cytokines including IL-1, IL-2, IL-6 and TNF-alpha in rabbit serum so as to provide theoretical basis for clinical application.

METHODSA total of 20 healthy adult rabbits were enrolled in the study and randomly divided into two groups (10 rabbits per group), i.e., control group (Group C) and HAES group (Group H). Under anesthesia of the rabbits, we performed incision of trachea, high-frequency jet ventilation and liberation of femoral artery and femoral veins. Group C was free from hemodilution. Group H was injected with dilution (2-fold of blood letting volume) via femoral veins during blood letting of the femoral artery. 6% HAES-steril plus compound solution of sodium lactate, with crystal/gel ratio of 2:1, blood letting volume = TBV x (Ho-Hf)/Hav. All blood was transfused back 60-120 min after blood letting. Venous blood was collected before blood letting (T0) and 30 min (T1), 60 min (T2), 120 min (T3) and 24 h(T4) after blood letting to detect Hb and Hct and measure level of IL-1, IL-2, IL-6 and TNF-alpha in serum.

RESULTSIn Group H, levels of IL-1, IL-2, IL-6 and TNF-alpha in serum were increased from T1 after ANH, reached peak at T3 but showed decrease at T4, with significant difference compared with Group C at T1, T2, T3 and T4 (P < 0.01) and significant difference compared with those before ANH (P <0.01). In Group C, there was no significant difference upon IL-1, IL-2, IL-6 and TNF-alpha in serum at different time points.

CONCLUSIONANH with HAES-balanced solution as diluting agent can up-regulate the levels of cytokines IL-1, IL-2, IL-6 and TNF-alpha in rabbit serum. In the meantime, ANH may arouse eustress with low intensity and short action time, which exerts effect of enhancing immune function of the organisms.

Animals ; Female ; Hemodilution ; methods ; Interleukin-1 ; blood ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Male ; Plasma Substitutes ; administration & dosage ; Rabbits ; Random Allocation ; Tumor Necrosis Factor-alpha ; blood

For reconstruction of the bony defect, various artificial substitutes were developed. Among them, there has been a study of calcium phosphate coated bone substitutes for increasing attachment of osteoblasts in vivo. The purpose of this study was to evaluate the effects of serum and platelet-rich plasma (PRP) on calcium phosphate coated culture plate for the initial attachment, proliferation and activity of osteoblasts. After sampling the blood from white rats and concentrating by centrifugation, the amount of attachment of PDGF-BB and TGF-beta on the calcium phosphate coated culture plate was measured. Cultured HOS and ROS 17/2.8 cell was measured on attachment level and proliferation rate of osteoblasts. Alkaline phosphatase activity of HOS and ROS 17/2.8 cell was measured for studying on the activating rate of osteoblast. 1. Counting the amount of platelets of seperated plasma and PRP, the average number of platelets was 177,003 cell/microliter in plasma, and 1,656,062 cell/microliter in PRP, which was about 9 times as high as in plasma. 2. Amount of PDGF-BB deposited at calcium phosphate coated plate had increased by the total amount of plasma and PRP on the culture plate, whereas TGF-betahad been deposited on the plate only when treated by 50microliter of PRP(p<0.01). 3. After plating serum and PRP for 3 hours, we attached with HOS and ROS17/2.8 cell for 1 hour and 4 hours. There were no significant difference of the attachment between serum and control group, whereas there were significantly difference of the attachment between depositioning of PRP and control group. 4. After attaching plasma and PRP for 3 hours, cell number has much increased when HOS and ROS17/2.8 cell had been cultured for 48 hours(p<0.05). 5. After attaching plasma and PRP for 3 hours, concentration of alkaline-phosphatase has increased when HOS and ROS17/2.8 cell had been cultured for 48 hours(p<0.01). These results suggested that PRP affected on initial cell attachment rather than proliferation and activation of osteoblasts at calcium phosphate coated plate.
Alkaline Phosphatase ; Animals ; Blood Platelets* ; Bone Substitutes ; Calcium ; Cell Count ; Centrifugation ; Osteoblasts* ; Plasma ; Platelet-Rich Plasma* ; Rats ; Transforming Growth Factor beta

For reconstruction of the bony defect, various artificial substitutes were developed. Among them, there has been a study of calcium phosphate coated bone substitutes for increasing attachment of osteoblasts in vivo. The purpose of this study was to evaluate the effects of serum and platelet-rich plasma (PRP) on calcium phosphate coated culture plate for the initial attachment, proliferation and activity of osteoblasts. After sampling the blood from white rats and concentrating by centrifugation, the amount of attachment of PDGF-BB and TGF-beta on the calcium phosphate coated culture plate was measured. Cultured HOS and ROS 17/2.8 cell was measured on attachment level and proliferation rate of osteoblasts. Alkaline phosphatase activity of HOS and ROS 17/2.8 cell was measured for studying on the activating rate of osteoblast. 1. Counting the amount of platelets of seperated plasma and PRP, the average number of platelets was 177,003 cell/microliter in plasma, and 1,656,062 cell/microliter in PRP, which was about 9 times as high as in plasma. 2. Amount of PDGF-BB deposited at calcium phosphate coated plate had increased by the total amount of plasma and PRP on the culture plate, whereas TGF-betahad been deposited on the plate only when treated by 50microliter of PRP(p<0.01). 3. After plating serum and PRP for 3 hours, we attached with HOS and ROS17/2.8 cell for 1 hour and 4 hours. There were no significant difference of the attachment between serum and control group, whereas there were significantly difference of the attachment between depositioning of PRP and control group. 4. After attaching plasma and PRP for 3 hours, cell number has much increased when HOS and ROS17/2.8 cell had been cultured for 48 hours(p<0.05). 5. After attaching plasma and PRP for 3 hours, concentration of alkaline-phosphatase has increased when HOS and ROS17/2.8 cell had been cultured for 48 hours(p<0.01). These results suggested that PRP affected on initial cell attachment rather than proliferation and activation of osteoblasts at calcium phosphate coated plate.
Alkaline Phosphatase ; Animals ; Blood Platelets* ; Bone Substitutes ; Calcium ; Cell Count ; Centrifugation ; Osteoblasts* ; Plasma ; Platelet-Rich Plasma* ; Rats ; Transforming Growth Factor beta

Starting from the form of red blood cells and the hematocrit (Hct, about 45 vol% of whole blood), we tried to prepare a kind of microspheres suspension to imitate non-Newtonian fluid property of whole blood, exploring its potentiality to be applied in blood viscosity quality control substance. In our study, we produced Ca-alginate hydrogel microspheres using emulsion polymerization, then we suspended the microspheres in 0.9 wt% NaCl solution to obtain a kind of liquid sample with the microspheres taking 45% volume. Then we used two types of viscometers to measure and analyse the changes of sample viscosity at different shear rate. We observed the forms of Ca-alginate hydrogel microspheres with microscope, and found them to be relatively complete, and their diameters to be normally distributed. Diameters of about 90% of the microspheres were distributed in a range from 6 to 22 micron. The samples were examined with viscometer FASCO-3010 and LG-R-80c respectively, both of which have shown a shear-thinning effect. After 5-week stability test, the CV of viscosity results corresponding to the two instruments were 7.3% to 13.8% and 8.9% to 14.2%, respectively. Although some differences existed among the results under the same shear rate, the general variation trends of the corresponding results were consistent, so the sample had the potentiality to be widely used in calibrating a different type of blood viscometer.
Alginates ; chemistry ; Blood Viscosity ; Calcium ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Humans ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemistry ; Microspheres ; Plasma Substitutes ; chemistry ; Rheology ; instrumentation ; Suspensions ; chemistry

Blood substitutes, especially red blood cell (RBC) substitutes, have been developed for the past five decades and have several advantages over allogenic packed RBCs, including a prolonged half-life, lack of a cross-matching requirement, and minimal infection risk or concerns about immunologic reactions. There are two main groups in RBC substitutes: perfluorochemicals and hemoglobin-based oxygen carriers (HBOCs). HBOCs are made of hemoglobins from: human, bovine or recombinant and undergo three modification types: chemical (intramolecular cross-linking, polymerization, conjugation to macromolecules and combination of several chemical modifications), genetic, or technological (microencapsulation). The types, side effects, current status of clinical trials, and the future of HBOCs are described in details.
Blood Substitutes ; Erythrocytes ; Half-Life ; Hemoglobins ; Humans ; Oxygen ; Polymerization ; Polymers

Blood substitutes, especially red blood cell (RBC) substitutes, have been developed for the past five decades and have several advantages over allogenic packed RBCs, including a prolonged half-life, lack of a cross-matching requirement, and minimal infection risk or concerns about immunologic reactions. There are two main groups in RBC substitutes: perfluorochemicals and hemoglobin-based oxygen carriers (HBOCs). HBOCs are made of hemoglobins from: human, bovine or recombinant and undergo three modification types: chemical (intramolecular cross-linking, polymerization, conjugation to macromolecules and combination of several chemical modifications), genetic, or technological (microencapsulation). The types, side effects, current status of clinical trials, and the future of HBOCs are described in details.
Blood Substitutes ; Erythrocytes ; Half-Life ; Hemoglobins ; Humans ; Oxygen ; Polymerization ; Polymers

BACKGROUND: The chemical modification of RBC surface antigen has many advantages for safe transfusion practice. We evaluated the change of antibody reactivity to RBC surface antigen before and after glutaraldehyde crosslinking. MATERIALS AND METHODS: The 10 mL of blood were collected from 20 volunteers and were treated by 2-3% glutaraldehyde at 4degrees C. After 30 minute incubation, Agglutinability of various RBC surface antigen (ABO, Rh-C, c, D, E, e) was measured by titration using anti-sera (Green Cross, Korea, Dade, USA), and compared the agglutinability changes before and after glutaraldehyde crosslinking. RESLUTS: The agglutinability of Rh surface antigens (D, C, c, E, e) was disappeared after glutaraldehyde crosslinking. However, ABO antigens (n=20) still showed strong agglutinability against antisera with some decreased. CONCLUSIONS: It would be useful to apply glutaraldehyde crossliked RBCs for rare blood group transfusion practice, if the safety problem were solved.
Antigens, Surface* ; Blood Substitutes ; Glutaral* ; Immune Sera ; Korea ; Volunteers