ArticleIntensive care medicine experimental2017
Volume-replacement ratio for crystalloids and colloids during bleeding and resuscitation: an animal experiment.
Article in Intensive care medicine experimental, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 18 citations in OpenAlex.
- Hypotension duration and vasopressor requirements following intrathecal oxytocin for Total hip arthroplasty: Secondary analysis of a randomized controlled trial.Journal of clinical anesthesia · 2023Trial
- The physiologic power of fluid circulation and implications for fluid therapy.Frontiers in veterinary science · 2026Review
- Interpretation of volume kinetics in terms of pharmacokinetic principles.Korean journal of anesthesiology · 2021Article
- [Perioperative fluid management in major abdominal surgery].Der Anaesthesist · 2021Review
- Intravenous Fluid Administration and the Coagulation System.Frontiers in veterinary science · 2021Review
- The Effects of Resuscitative Fluid Therapy on the Endothelial Surface Layer.Frontiers in veterinary science · 2021Review
- Editorial: Fluid Therapy in Animals: Physiologic Principles and Contemporary Fluid Resuscitation Considerations.Frontiers in veterinary science · 2021Article
- Population-based volume kinetics of crystalloids and colloids in healthy volunteers.Scientific reports · 2019Article
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundFluid resuscitation remains a cornerstone in the management of acute bleeding. According to Starling's "Three-compartment model", four-times more crystalloids have the same volume effect as colloids. However, this volume-replacement ratio remains a controversial issue as it may be affected by the degradation of the endothelial glycocalyx layer, a situation often found in the critically ill. Our aim was to compare colloid and crystalloid based fluid resuscitation during an experimental stroke volume index (SVI) guided hemorrhage and resuscitation animal model.
methodsAnesthetized and mechanically ventilated pigs were randomized to receive a colloid (Voluven®,HES, n=15) or crystalloid (Ringerfundin®,RF, n=15) infusion. Animals were bled till baseline SVI (Tbsl) dropped by 50% (T0), followed by resuscitation until initial SVI was reached (T4) in four steps. Invasive hemodynamic measurements, blood gas analyses and laboratory tests were performed at each assessment points. Glycocalyx degradation markers (Syndecan-1/hematocrit ratio, Glypican/hematocrit ratio) were determined at Tbsl, T0 and T4.
resultsSimilar amounts of blood were shed in both groups (HES group: 506±159 mls blood, RF group: 470±127 mls blood). Hemodynamic changes followed the same pattern without significant difference between the groups. Animals received significantly less resuscitation fluid in the HES compared to the RF-group: 425 [320-665], vs 1390 [884-1585] mls, p <0.001. The volume replacement ratio was 0.92 [0.79-1.54] for HES; and 3.03 [2.00-4.23] for the RF-group (p <0.001). There was no significant difference between the groups in the glycocalyx degradation markers.
conclusionIn this moderate bleeding-resuscitation animal model the volume-replacement ratio for crystalloids and colloids followed similar patterns as predicted by Starling's principle, and the glycocalyx remained intact. This indicates that in acute bleeding events, such as trauma or during surgery, colloids may be beneficial as hemodynamic stability may be achieved more rapidly than with crystalloids.
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