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Christer Svensen - One of the best experts on this subject based on the ideXlab platform.
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Hypoproteinemia does not alter plasma volume expansion in response to a 0 9 saline bolus in awake sheep
Critical Care Medicine, 2010Co-Authors: K I Brauer, Lance P Brauer, Donald S Prough, Peter Rodhe, Robert G Hahn, Daniel L Traber, Lilian D Traber, Christer SvensenAbstract:Objective: To test the hypothesis that Hypoproteinemia reduces plasma volume expansion produced by a bolus of crystalloid solution given to awake sheep. Design: Prospective and observational. Setting: Laboratory. Subjects: Five female merino sheep (n = 5) weighing 37 +/- 3 kg were anesthetized. Interventions: Each animal was subjected to a 5-day test period: day 1: 50 mL/min 0.9% saline infusion over 20 mins. Days 2-4: daily plasmapheresis and replacement of the shed plasma with 6 L of 0.9% saline were performed in increments. Measurements and Main Results: Fractional plasma volume expansion after rapid infusion of saline on days 1 and 5 was calculated from changes in hemoglobin concentration. There was a significant reduction in total plasma protein concentration after plasmapheresis (p andlt; .05). Colloid osmotic pressures were also significantly lowered (p andlt; .05). A crystalloid infusion of 0.9% saline did not alter any of these values compared with baseline. The hemodynamic measurements did not show significant differences between the experiments. The plasma volume expansion reached approximately 20% at the end of infusion and stayed at 10-15% during the experiments. No difference was found in plasma volume expansion produced by a bolus of 50 mL/min of 0.9% in the hypoproteinemic state when compared with the euproteinemic state (p = .61). No difference in cumulative urinary output was found between the two states. Conclusions: In contrast to our hypothesis, severe acute Hypoproteinemia does not reduce plasma volume expansion in response to 50 mL/min 0.9% saline infusion in nonspleenectomized sheep when compared with the resultant plasma volume expansion after a 50 mL/min of 0.9% infusion in the euproteinemic state.
Jean-bernard Gouyon - One of the best experts on this subject based on the ideXlab platform.
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Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
Journal of Perinatology, 2012Co-Authors: Silvia Iacobelli, Francesco Bonsante, C. Lacoutière, Cyril Ferdynus, J. Cottenet, Christine Binquet, Catherine Quantin, Jean-bernard GouyonAbstract:Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
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Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
Journal of Perinatology: Official Journal of the California Perinatal Association, 2012Co-Authors: Silvia Iacobelli, Francesco Bonsante, C. Lacoutière, Cyril Ferdynus, J. Cottenet, Christine Binquet, Catherine Quantin, Jean-bernard GouyonAbstract:OBJECTIVE: We aimed to investigate the relationship between day-1 Hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available. RESULT: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level \textless40 g l(-1)) on day 1 of life occurred in 19.5 % of all patients. The rate of SAO was 33.7% in patients with Hypoproteinemia and 9.9% in those with normoproteinemia (P\textless0.0001). Logistic and multiple regression analysis confirmed that the association Hypoproteinemia-SAO remained significant after adjustment for the other major predictors of outcome present at baseline (odds ratio 3.4; 95% confidence interval 2.1-5.4; P\textless0.0001). CONCLUSION: Hypoproteinemia was highly associated with SAO in this cohort of critically ill preterm infants. We are unable to explain the link between Hypoproteinemia and adverse outcome in our population. This investigation serves as a hypothesis-generating report of a large preterm infants sample, and suggests the need to assess the predictive accuracy for adverse outcome of Hypoproteinemia in future prospective studies.
Bruce A Harms - One of the best experts on this subject based on the ideXlab platform.
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a simplified two pore filtration model explains the effects of Hypoproteinemia on lung and soft tissue lymph flux in awake sheep
Microvascular Research, 1992Co-Authors: Robert L Conhaim, Bruce A HarmsAbstract:Abstract We used a simplified two-pore filtration model to examine the effects of Hypoproteinemia on lung and soft tissue lymph flux in awake sheep (n = 7). To induce Hypoproteinemia, we subjected each animal to 3 days of batch plasmapheresis (6 units per day). Data were collected in near steady-state conditions, 15–18 hr following completion of the last plasmapheresis episode. At this time, plasma protein concentration had fallen by 34%, while lung and soft tissue lymph protein concentrations had fallen by 55 and 62%, respectively. Lung and soft tissue lymph flows increased 52 and 87%, respectively. The plasma-to-lymph osmotic pressure gradients for lung and soft tissue lymph were unchanged by protein depletion (soft tissue, 7.7 mm Hg; lung, 4.8 mm Hg). We applied these results to a heteropore model of the microvascular barrier that consisted of two types of pores: those which plasma proteins could not cross (σ = 1) and those which proteins could cross without restriction (σ = 0). We varied the proportion of small pores to large pores until the measured data fit a model in which the calculated microvascular hydrostatic pressures in normal and hypoproteinemic conditions were equal. This was based on the assumption that microvascular hydrostatic pressure did not change with plasma protein depletion. These conditions could be satisfied when the small pores accounted for 90% of total barrier porosity. According to the model, lymph flow increased in Hypoproteinemia because of an increase in protein-free liquid flux through the large percentage of small pores; protein flux through the small percentage of large pores remained unchanged. The net result was an increase in lymph flow and a decrease in the lymph protein concentration. The model reproduced these changes even though the plasma-to-lymph osmotic pressure gradients were unchanged. We conclude that a simplified heteropore model can explain the effects of Hypoproteinemia on lung and soft tissue lymph flux.
Christine Binquet - One of the best experts on this subject based on the ideXlab platform.
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Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
Journal of Perinatology, 2012Co-Authors: Silvia Iacobelli, Francesco Bonsante, C. Lacoutière, Cyril Ferdynus, J. Cottenet, Christine Binquet, Catherine Quantin, Jean-bernard GouyonAbstract:Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
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Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
Journal of Perinatology: Official Journal of the California Perinatal Association, 2012Co-Authors: Silvia Iacobelli, Francesco Bonsante, C. Lacoutière, Cyril Ferdynus, J. Cottenet, Christine Binquet, Catherine Quantin, Jean-bernard GouyonAbstract:OBJECTIVE: We aimed to investigate the relationship between day-1 Hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available. RESULT: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level \textless40 g l(-1)) on day 1 of life occurred in 19.5 % of all patients. The rate of SAO was 33.7% in patients with Hypoproteinemia and 9.9% in those with normoproteinemia (P\textless0.0001). Logistic and multiple regression analysis confirmed that the association Hypoproteinemia-SAO remained significant after adjustment for the other major predictors of outcome present at baseline (odds ratio 3.4; 95% confidence interval 2.1-5.4; P\textless0.0001). CONCLUSION: Hypoproteinemia was highly associated with SAO in this cohort of critically ill preterm infants. We are unable to explain the link between Hypoproteinemia and adverse outcome in our population. This investigation serves as a hypothesis-generating report of a large preterm infants sample, and suggests the need to assess the predictive accuracy for adverse outcome of Hypoproteinemia in future prospective studies.
Silvia Iacobelli - One of the best experts on this subject based on the ideXlab platform.
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Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
Journal of Perinatology, 2012Co-Authors: Silvia Iacobelli, Francesco Bonsante, C. Lacoutière, Cyril Ferdynus, J. Cottenet, Christine Binquet, Catherine Quantin, Jean-bernard GouyonAbstract:Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
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Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit
Journal of Perinatology: Official Journal of the California Perinatal Association, 2012Co-Authors: Silvia Iacobelli, Francesco Bonsante, C. Lacoutière, Cyril Ferdynus, J. Cottenet, Christine Binquet, Catherine Quantin, Jean-bernard GouyonAbstract:OBJECTIVE: We aimed to investigate the relationship between day-1 Hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available. RESULT: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level \textless40 g l(-1)) on day 1 of life occurred in 19.5 % of all patients. The rate of SAO was 33.7% in patients with Hypoproteinemia and 9.9% in those with normoproteinemia (P\textless0.0001). Logistic and multiple regression analysis confirmed that the association Hypoproteinemia-SAO remained significant after adjustment for the other major predictors of outcome present at baseline (odds ratio 3.4; 95% confidence interval 2.1-5.4; P\textless0.0001). CONCLUSION: Hypoproteinemia was highly associated with SAO in this cohort of critically ill preterm infants. We are unable to explain the link between Hypoproteinemia and adverse outcome in our population. This investigation serves as a hypothesis-generating report of a large preterm infants sample, and suggests the need to assess the predictive accuracy for adverse outcome of Hypoproteinemia in future prospective studies.