Document Detail


Improving cardiac function with new-generation plasma volume expanders.
MedLine Citation:
PMID:  22867830     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Plasma expander (PE) based on polyethylene glycol (PEG) conjugated to albumin has shown positive results maintaining blood volume during hemodilution and restoring blood volume during resuscitation from hemorrhagic shock. Polyethylene glycol conjugation to human serum albumin (HSA), PEG-HSA, increases size, weight, and colloidal osmotic pressure, with minor effects on solution viscosity.
METHODS: This study was designed to test the hypothesis that PEG-HSA (2 g/dL) produced by direct PEGylation chemistry improves cardiac function during 2 experimental models, (i) moderate hemodilution and (ii) resuscitation from hemorrhagic shock, compared with a conventional colloidal PE (Dextran 70 kd [Dx70], 6 g/dL). Cardiac function was studied using a miniaturized pressure volume conductance catheter implanted in the left ventricle and evaluated in terms of cardiac indices derived from the pressure volume measurements.
RESULTS: Polyethylene glycol-HSA increased cardiac output, stroke volume, and stroke work and decreased systemic vascular resistance compared with Dx70 in both experimental models. The improvements induced by PEG-HSA in cardiac function were sustained over the observation time. Polyethylene glycol-HSA cardiac mechanoenergetics changes are the result of increased energy transferred per stroke and decreased resistance of the vasculature connecting the heart. In summary, PEG-HSA decreased left ventricle ejection impedance.
CONCLUSION: Ejection of blood diluted with PEG-HSA presented a reduced load to the heart, increased contractile function, and lowered the energy consumed per unit volume compared with Dx70. Our results emphasize the importance of heart function as a parameter to be included in the evaluation changes induced by new PEs.
Authors:
Surapong Chatpun; Parimala Nacharaju; Pedro Cabrales
Publication Detail:
Type:  Journal Article     Date:  2012-08-03
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  31     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-10     Completed Date:  2013-03-14     Revised Date:  2014-06-06    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  54-63     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Blood Volume / drug effects*
Cardiac Catheterization
Cardiac Output / drug effects*
Cricetinae
Hemodilution / methods*
Male
Mesocricetus
Plasma Substitutes / pharmacology*
Polyethylene Glycols / pharmacology*
Resuscitation / methods
Serum Albumin / pharmacology*
Shock, Hemorrhagic / drug therapy*
Vascular Resistance / drug effects
Ventricular Function, Left / drug effects*
Grant Support
ID/Acronym/Agency:
P01 HL071064/HL/NHLBI NIH HHS; P01 HL110900/HL/NHLBI NIH HHS; R01 HL052684/HL/NHLBI NIH HHS; R01 HL062354/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Plasma Substitutes; 0/Polyethylene Glycols; 0/Serum Albumin
Comments/Corrections

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