Bolld volume in 10 adult rabbits were measured by means of RISA dilution. The values were: eye plasma volume 0.0093 ml/gm eye, eye bolld volume 0.016 ml/gm eye and total blood volume of whole eye was 0.043 +/- 0.013(S.D.) ml. Total body plasma volume obtained simultaneously was 4.0% body weight and total body blood volume 6.9% body weight.
Adult ; Blood Volume* ; Body Weight ; Humans ; Plasma Volume ; Rabbits

We evaluated clinical effects and side effects of plasma exchange(PE) in patients with severe Guillain-Barre syndrome(GBS). Two plasma volumes were exchanged 3 times on an alternate-day base(total 6 plasma volumes) in eight patients with severe GBS. Exchange fluid used was fresh frozen plasma(FFP) or human albumin. Intervals taken for patients to walk with support were significantly shorter than eight control patients. GBS of the similar grades(p<0.05). Effects were not related to age, sex, or initial CSF protein levels. After PE, thrombocytopenia followed in all patients, most remarkably after the first PE. Degree of platelet reduction correlated significantly with the time taken for each PE and the plasma flow rate during PE. But they resolved spontaneously in all cases within 2 to 11 days after the last PE. Other side effects included urticaria, paresthesia dyspnea, hemorrhagic spots on the skin, and chilly sense, all of which were transient. These results suggest that PE could promote early improvement in severe GBS with relative safety, if performed early in the course of the illness.
Blood Platelets ; Dyspnea ; Guillain-Barre Syndrome* ; Humans ; Paresthesia ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Skin ; Thrombocytopenia ; Urticaria

BACKGROUND: The Spectra Optia (SPO) is a novel continuous-flow centrifugal apheresis system based on the COBE Spectra (CSP) platform. There have been few attempts to validate the advantages of the SPO. We performed a retrospective study comparing the two cell separators for therapeutic plasma exchange (TPE) procedures in kidney transplant (KT) patients and seeing efficacy and safety. METHODS: We analyzed 720 TPE procedures performed between August 2012 and July 2014. Procedures included desensitization TPE before KT and TPE for the management of acute and chronic antibody-mediated graft rejection. Demographic characteristics, operational TPE variables, and laboratory data were analyzed. RESULTS: Demographic characteristics for the SPO (n=389) and CSP (n=331) groups did not differ significantly. The procedure time to exchange one plasma volume was 94.2+/-10.3 min in the SPO group and 100.4+/-11.2 min in the CSP group (P<0.001). The plasma removal efficiency (PRE) was 92.5+/-4.9% in the SPO group and 83.2+/-3.7% in the CSP group (P<0.001). There were no significant differences across the two apheresis systems for changes in hematologic parameters. CONCLUSIONS: Compared with the CSP, the SPO was associated with an improved PRE and a shorter procedure time to exchange one plasma volume. Our results in KT patients show that the SPO is superior to the CSP in TPE procedures.
Blood Component Removal ; Graft Rejection ; Humans ; Kidney ; Kidney Transplantation ; Plasma ; Plasma Exchange* ; Plasma Volume ; Retrospective Studies

Adequate restoration of intravascular volume remains an important therapeutic maneuver in managing the surgical patient. Definition of the ideal volume replacement strategy still remains one of the burning problems. Firstly, the choice between colloid and crystalloid solutions continues to generate controversy. Secondly, the highly controversial crystalloid/colloid dispute has been enlarged to a colloid/colloid debate because of the increasing number of colloids that are available. And lastly, whether high or low volume replacement strategies are favorable for the surgical patient is an another issue for the anesthesiologists. Volume replacement has been hitherto often based on art, dogma and personal beliefs. It was the aim of this overview to present the different solutions and to facilitate the strategies for above three main issues in the field of intraoperative fluid therapy.
Burns ; Colloids ; Dissent and Disputes ; Fluid Therapy ; Humans ; Isotonic Solutions ; Plasma ; Plasma Substitutes ; Plasma Volume

BACKGROUND: The prediction of the postoperative cardiac complications is important in the medical management of patients undergoing noncardiac surgery. Several indices have been developed to predict the outcome, but their usefulness has neither been evaluated nor been widely used. The purpose of this study was to assess the NT-proBNP as a prognostic factor for the prediction of the postoperative cardiac risk as compared with the existing cardiac indices in elderly patients undergoing orthopedic surgery. METHODS: From September 2003 to January 2004, we examined 50 patients older than 60 years, who were scheduled to undergo orthopedic surgery. The plasma NT-proBNP concentration, clinical cardiac indices and left ventricular ejection fraction were measured prior to the operation. The postoperative outcomes were followed and predictors for postoperative cardiac risk were identified. RESULTS: Cardiac complications occurred in 22% of the patients. A statistically significant increase in the cardiac complications was observed in the patients with higher plasma concentration of NT-proBNP (p<0.001), higher original cardiac index score (p<0.001), higher revised cardiac index score (p=0.004) and that fell into the major group of the American college of cardiology/American heart association guidelines (p=0.018). The NT-proBNP concentrations were positively correlated with the original cardiac index score (r=0.666, p<0.001), revised cardiac index score (r=0.429, p=0.002) and grouping by the ACC/AHA guidelines (r=0.497, p<0.001). The area under the receiver-operating characteristic curve for the plasma NT-proBNP (0.946, 95% CI) was superior to the other cardiac indices. The optimal cut-off point for the prediction of postoperative cardiac complications occurred at a plasma NT-proBNP, concentration of 539.3 pg/mL and provided a 90.9% sensitivity, 92.3% sensitivity, 79.9% positive predictive value and 97.3% negative predictive value. The independent predictors for postoperative adverse cardiac event were age and Goldman index. CONCLUSION: The plasma NT-proBNP level may be a useful parameter for the prediction of postoperative cardiac complications.
Aged* ; Heart ; Humans ; Orthopedics ; Plasma* ; Risk Assessment ; Stroke Volume

Dextran 40, a polysaccharide with molecular weight of 40,000, has been used clinically for expansion of plasma volume, improvement of microcirculation in low flow states and thromboprophylaxis especially in major operation such as vascular and hip surgery. However severe anaphylactoid reaction to dextran 40 can occur rarely. We experienced a case of cardisc arrest due to a severe reaction of dextran 40 in a patient who underwent aortofemoral bypass surgery. The patient was resuscitated immediately and followed up carefully.
Dextrans* ; Heart Arrest ; Hip ; Humans ; Microcirculation ; Molecular Weight ; Plasma Volume

Dextran 40, a polysaccharide with molecular weight of 40,000, has been used clinically for expansion of plasma volume, improvement of microcirculation in low flow states and thromboprophylaxis especially in major operation such as vascular and hip surgery. However severe anaphylactoid reaction to dextran 40 can occur rarely. We experienced a case of cardisc arrest due to a severe reaction of dextran 40 in a patient who underwent aortofemoral bypass surgery. The patient was resuscitated immediately and followed up carefully.
Dextrans* ; Heart Arrest ; Hip ; Humans ; Microcirculation ; Molecular Weight ; Plasma Volume

Plasma CO2 gas tension, tidal volume and peak inspiratory airway pressure were investigated before CO2gas insufflation, 30 minutes and 60 minutes after gas insufflation in 32 laparoscopic surgery patients to study the effects of intraabdominal CO2 gas insufflation during laparoscopic surgery under general endotracheal anesthesia with controlled ventilation. Our results were as follows 1) Arterial CO2 gas tension values were significantly higher 30 minutes after CO2 gas insufflation compared to before gas insufflation(36.8+/-4.2 mmHg vs. 28.3+/-6.8 mmHg). 2) Tidal volume was increased 30 minutes after CO2 gas insufflation compared to before gas insufflation(505.1+/-78.2 ml vs. 462.0+/-83.2 ml). 3) Peak inspiratory airway pressure was significantly increased 30 minutes after CO2 gas insufflation compared to before gas insufflation(16.4+/-1.7 cmH2O vs. 9.8+/-1.0 cmH2O). And these increasing states were maintained during laparoscopic surgery. As the above results show, during laparoscopic surgery using CO2 gas insufflation under general anesthesia with controlled ventilation, arterial CO2 gas tension, tidal volume and peak inspiratory airway pressure were significantly increased 30 minutes after CO2 gas insufflation. Cautions may be advised if laparoscopic surgery, by whatever operation, is indicated in subjects who are affected by increasing PaCO2 and peak inspiratory airway pressure.
Anesthesia ; Anesthesia, General* ; Humans ; Insufflation* ; Laparoscopy* ; Plasma ; Tidal Volume* ; Ventilation

No abstract available.
Blood Volume* ; Hypotension* ; Nitric Oxide* ; Plasma* ; Renal Dialysis*

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