Improving cardiac function with new-generation plasma volume expanders

Surapong Chatpun, Parimala Nacharaju, Pedro Cabrales

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)54-63
Number of pages10
JournalAmerican Journal of Emergency Medicine
Volume31
Issue number1
DOIs
StatePublished - Jan 2013

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Plasma Substitutes
Serum Albumin
Dextrans
Hemodilution
Hemorrhagic Shock
Blood Volume
Resuscitation
Heart Ventricles
Theoretical Models
Pressure
Osmotic Pressure
Electric Impedance
Viscosity
Cardiac Output
Vascular Resistance
Stroke Volume
Albumins
Catheters
Stroke
Observation

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Improving cardiac function with new-generation plasma volume expanders. / Chatpun, Surapong; Nacharaju, Parimala; Cabrales, Pedro.

In: American Journal of Emergency Medicine, Vol. 31, No. 1, 01.2013, p. 54-63.

Research output: Contribution to journalArticle

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