Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage

C. Makena Hightower, Beatriz Y. Salazar Vázquez, Pedro Cabrales, Amy G. Tsai, Seetharama A. Acharya, Marcos Intaglietta

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: Treating hemorrhage with blood transfusions in subjects previously hemodiluted with different colloidal plasma expanders, using fresh autologous blood or blood that has been stored for 2 weeks, allows identifying the interaction between type of plasma expander and differences in blood storage. STUDY DESIGN AND METHODS: Studies used the hamster window chamber model. Fresh autologous plasma, 130-kDa starch-based plasma expander (hydroxyethyl starch [HES]), or 4% polyethylene glycol-conjugated albumin (PEG-Alb) was used for 20% of blood volume (BV) hemodilution. Hemodilution was followed by a 55% by BV 40-minute hemorrhagic shock period, treated with transfusion of fresh or blood that was stored for 2 weeks. Outcome was evaluated 1 hour after blood transfusion in terms of microvascular and systemic variables. RESULTS: Results were principally dependent on the type of colloidal solution used during hemodilution, 4% PEG-Alb yielding the best microvascular recovery evaluated in terms of the functional capillary density. This result was consistent whether fresh blood or stored blood was used in treating the subsequent shock period. Fresh blood results were significantly better in systemic and microvascular terms relative to stored blood. HES and fresh plasma hemodilution yielded less favorable results, a difference that was enhanced when fresh versus stored blood was compared in their efficacy of correcting the subsequent hemorrhage. CONCLUSION: The type of plasma expander used for hemodilution influences the short-term outcome of subsequent volume resuscitation using blood transfusion, 4% PEG-Alb providing the most favorable outcome by comparison to HES or fresh plasma.

Original languageEnglish (US)
Pages (from-to)49-59
Number of pages11
JournalTransfusion
Volume53
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Plasma Substitutes
Perfusion
Hemorrhage
Hemodilution
Starch
Blood Transfusion
Albumins
Blood Volume
Hemorrhagic Shock
Resuscitation
Cricetinae
Shock

ASJC Scopus subject areas

  • Hematology
  • Immunology
  • Immunology and Allergy

Cite this

Hightower, C. M., Salazar Vázquez, B. Y., Cabrales, P., Tsai, A. G., Acharya, S. A., & Intaglietta, M. (2013). Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage. Transfusion, 53(1), 49-59. https://doi.org/10.1111/j.1537-2995.2012.03679.x

Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage. / Hightower, C. Makena; Salazar Vázquez, Beatriz Y.; Cabrales, Pedro; Tsai, Amy G.; Acharya, Seetharama A.; Intaglietta, Marcos.

In: Transfusion, Vol. 53, No. 1, 01.2013, p. 49-59.

Research output: Contribution to journalArticle

Hightower, CM, Salazar Vázquez, BY, Cabrales, P, Tsai, AG, Acharya, SA & Intaglietta, M 2013, 'Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage', Transfusion, vol. 53, no. 1, pp. 49-59. https://doi.org/10.1111/j.1537-2995.2012.03679.x
Hightower CM, Salazar Vázquez BY, Cabrales P, Tsai AG, Acharya SA, Intaglietta M. Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage. Transfusion. 2013 Jan;53(1):49-59. https://doi.org/10.1111/j.1537-2995.2012.03679.x
Hightower, C. Makena ; Salazar Vázquez, Beatriz Y. ; Cabrales, Pedro ; Tsai, Amy G. ; Acharya, Seetharama A. ; Intaglietta, Marcos. / Plasma expander and blood storage effects on capillary perfusion in transfusion after hemorrhage. In: Transfusion. 2013 ; Vol. 53, No. 1. pp. 49-59.
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abstract = "BACKGROUND: Treating hemorrhage with blood transfusions in subjects previously hemodiluted with different colloidal plasma expanders, using fresh autologous blood or blood that has been stored for 2 weeks, allows identifying the interaction between type of plasma expander and differences in blood storage. STUDY DESIGN AND METHODS: Studies used the hamster window chamber model. Fresh autologous plasma, 130-kDa starch-based plasma expander (hydroxyethyl starch [HES]), or 4{\%} polyethylene glycol-conjugated albumin (PEG-Alb) was used for 20{\%} of blood volume (BV) hemodilution. Hemodilution was followed by a 55{\%} by BV 40-minute hemorrhagic shock period, treated with transfusion of fresh or blood that was stored for 2 weeks. Outcome was evaluated 1 hour after blood transfusion in terms of microvascular and systemic variables. RESULTS: Results were principally dependent on the type of colloidal solution used during hemodilution, 4{\%} PEG-Alb yielding the best microvascular recovery evaluated in terms of the functional capillary density. This result was consistent whether fresh blood or stored blood was used in treating the subsequent shock period. Fresh blood results were significantly better in systemic and microvascular terms relative to stored blood. HES and fresh plasma hemodilution yielded less favorable results, a difference that was enhanced when fresh versus stored blood was compared in their efficacy of correcting the subsequent hemorrhage. CONCLUSION: The type of plasma expander used for hemodilution influences the short-term outcome of subsequent volume resuscitation using blood transfusion, 4{\%} PEG-Alb providing the most favorable outcome by comparison to HES or fresh plasma.",
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