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Importance of the Infusion Rate for the Plasma Expanding Effect of 5% Albumin, 6% HES 130/0.4, 4% Gelatin, and 0.9% NaCl in the Septic Rat*

Bark, Björn P. MD; Persson, Johan MD, PhD; Grände, Per-Olof MD, PhD

doi: 10.1097/CCM.0b013e318274157e
Laboratory Investigations
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Objectives: To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9% NaCl in a rat sepsis model and to compare the plasma-expanding effect among these fluids.

Design: Prospective, randomized animal study.

Setting: University hospital laboratory.

Subjects: One hundred and twelve adult male rats.

Interventions: Sepsis was induced by cecal ligation and incision followed by closure of the abdomen. After 3 hrs, an infusion of the PV expander under study was started at a volume of 12mL/kg for the colloids and of 48mL/kg for 0.9% NaCl, either for 15 mins or for 3 hrs. A control group underwent the same experimental procedure but no fluid was given.

Measurements and Main Results: Three hours after start of the infusion (end of experiment), the plasma-expanding effect was better with a slow than a fast infusion rate for the colloids, especially albumin, but the NaCl groups did not differ significantly from the control group. The PV for the control group was 28.7±3mL/kg. In the slow and the fast infusion groups, it was 38.9±4.3 and 32.6±4.2mL/kg for albumin (p < 0.001), 32.9±4.3 and 29.5±4.4mL/kg for hydroxyethyl starch 130/0.4 (p < 0.05), 31.8±3.9 and 28.2±4.1mL/kg for gelatin (p < 0.05), and 31.8±5.3 and 30.7±6.6mL/kg for NaCl (n.s), respectively.

Conclusions: The study showed that the PV expansion by a colloid was greater when given at a slow than at a fast infusion rate, an effect more pronounced for albumin. This difference was not seen for NaCl. The PV-expanding effect was poor for NaCl and better for albumin than for the other colloids.

All authors: Department of Anesthesia and Intensive Care, Lund University and Lund University Hospital, Lund, Sweden.

* See also p. 931.

This study was supported by the Swedish Research Council, Stockholm, Sweden (11581), and Region Skåne (ALF 18401).

The authors have not disclosed any potential conflicts of interest.

Address requests for reprints to: Per-Olof Grände, MD, PhD, Department of Anesthesia and Intensive Care, Lund University Hospital, SE-221 85 Lund, Sweden. E-mail: per-olof.grande@med.lu.se

© 2013 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins