ArticleIntensive care medicine experimental2021
Interstitial washdown and vascular albumin refill during fluid infusion: novel kinetic analysis from three clinical trials.
Article in Intensive care medicine experimental, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 29 citations in OpenAlex.
- Albumin 20% in surgical and critically ill patients; a comprehensive review.Critical care (London, England) · 2026Review
- Temporal Dissociation Between Intravascular Albumin Mass and Transcapillary Escape Dynamics in Sepsis: A Longitudinal Characterization of Albumin Homeostasis Using Routine Laboratory Parameters.Journal of clinical medicine · 2026Article
- Vasoactive drugs and the distribution of crystalloid fluid during acute sepsis.Journal of intensive medicine · 2026Article
- Physiology and Molecular Mechanisms of the "Third Fluid Space".Journal of clinical medicine · 2025Review
- Where does the fluid go?Annals of intensive care · 2025Review
- Temporal Decline in Intravascular Albumin Mass and Its Association with Fluid Balance and Mortality in Sepsis: A Prospective Observational Study.Journal of clinical medicine · 2025Article
- Phenotype-specific dynamics of serum albumin and their impact on sepsis mortality.Biomarkers in medicine · 2025Observational
- Exploring treatment effects and fluid resuscitation strategies in septic shock: a deep learning-based causal inference approach.Scientific reports · 2025Article
- Effects of haemorrhage and lactated Ringer's solution or tetrastarch 130/0.4 resuscitation on colloidal osmotic pressure and osmolality in cats.Journal of feline medicine and surgery · 2025Article
- Volume kinetics in a translational porcine model of stabilized sepsis with fluid accumulation.Critical care (London, England) · 2025Article
- Dosing Adjustments in Cases of Altered Plasma Protein Binding are Most Needed for Drugs with a Volume of Distribution Below 1.3 L/kg.Clinical pharmacokinetics · 2024Article
- Accelerated lymph flow from infusion of crystalloid fluid during general anesthesia.BMC anesthesiology · 2024Article
- Role of the interstitium during septic shock: a key to the understanding of fluid dynamics?Journal of intensive care · 2023Review
- Hypovolemia with peripheral edema: What is wrong?Critical care (London, England) · 2023Review
- Interstitial washdown during crystalloid fluid loading in graded hypovolemia -A retrospective analysis in volunteers.Clinical hemorheology and microcirculation · 2023Article
- Pathophysiology of fluid administration in critically ill patients.Intensive care medicine experimental · 2022Review
- Albumin Kinetics in Sepsis and COVID-19.Critical care explorations · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsIncreased capillary filtration may paradoxically accelerate vascular refill of both fluid and albumin from the interstitial space, which is claimed to be edema-preventing. We characterized this proposed mechanism, called "interstitial washdown", by kinetic analyses of the hemodilution induced by intravenous infusion of crystalloid fluid during 3 distinct physiological states.
methodsGreater plasma dilution of hemoglobin as compared to albumin during fluid therapy indicated recruitment of albumin, which was compared to the flow of interstitial fluid to the plasma as indicated by population volume kinetic analysis. Data for the comparison were derived from 24 infusions of crystalloid fluid in conscious volunteers, 30 in anesthetized patients, and 31 in patients with ketoacidosis from hyperglycemia.
results"Interstitial washdown" increased the plasma albumin concentration by between 0.3 and 1.0 g/L in the three series of infusions. The initial albumin concentration in the interstitial fluid returning to the plasma was estimated to between 22 g/L and 29 g/L, which decreased to an average of 50-75% lower during the subsequent 2-3 h. Kinetic simulations show that pronounced washdown was associated with increased capillary filtration (high k
conclusionsCrystalloid fluid accelerates lymphatic flow that moderately increases plasma albumin, but more clearly helps to maintain the intravascular volume. This "interstitial washdown" mechanism becomes exhausted after a few hours.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.