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Björn P. Bark - One of the best experts on this subject based on the ideXlab platform.
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albumin Infusion Rate and plasma volume expansion a randomized clinical trial in postoperative patients after major surgery
Critical Care, 2019Co-Authors: Svajunas Statkevicius, Björn P. Bark, Johan Bonnevier, Jane Fisher, Erik Larsson, Carl M Oberg, Paivi Kannisto, Bobby Tingstedt, Peter BentzerAbstract:Optimal Infusion Rate of colloids in patients with suspected hypovolemia is unknown, and the primary objective of the present study was to test if plasma volume expansion by 5% albumin is greater if fluid is administered slowly rather than rapidly. Patients with signs of hypoperfusion after major abdominal surgery were randomized to intravenous Infusion of 5% albumin at a dose of 10 ml/kg (ideal body weight) either rapidly (30 min) or slowly (180 min). Plasma volume was measured using radiolabeled albumin at baseline, at 30 min, and at 180 min after the start of Infusion. Primary outcome was change in plasma volume from the start of Infusion to 180 min after the start of Infusion. Secondary outcomes included the change in the area under the plasma volume curve and transcapillary escape Rate (TER) for albumin from 180 to 240 min after the start of albumin Infusion. A total of 33 and 31 patients were included in the analysis in the slow and rapid groups, respectively. The change in plasma volume from the start of Infusion to 180 min did not differ between the slow and rapid Infusion groups (7.4 ± 2.6 vs. 6.5 ± 4.1 ml/kg; absolute difference, 0.9 ml/kg [95%CI, − 0.8 to 2.6], P = 0.301). Change in the area under the plasma volume curve was smaller in the slow than in the rapid Infusion group and was 866 ± 341 and 1226 ± 419 min ml/kg, respectively, P < 0.001. TER for albumin did not differ and was 5.3 ± 3.1%/h and 5.4 ± 3%/h in the slow and in the rapid Infusion groups, respectively, P = 0.931. This study does not support our hypothesis that a slow Infusion of colloid results in a greater plasma volume expansion than a rapid Infusion. Instead, our result of a smaller change in the area under the plasma volume curve indicates that a slow Infusion results in a less efficient plasma volume expansion, but further studies are required to confirm this finding. A rapid Infusion has no effect on vascular leak as measured after completion of the Infusion. EudraCT2013-004446-42 registered December 23, 2014.
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Infusion Rate and plasma volume expansion of dextran and albumin in the septic guinea pig.
Acta Anaesthesiologica Scandinavica, 2013Co-Authors: Björn P. Bark, Per-olof GrändeAbstract:Intravenous fluid treatment of hypovolaemia in states of increased capillary permeability, e.g. sepsis, is often accompanied by adverse oedema formation. A challenge is therefore to achieve and maintain normovolaemia using as little plasma volume substitution as possible to minimise interstitial oedema. In the present study, we evaluated the importance of Infusion Rate for the plasma volume expanding effects of 6% dextran 70 and 5% human albumin in a guinea pig sepsis model.
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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
Critical Care Medicine, 2013Co-Authors: Björn P. Bark, Johan Persson, Per-olof GrändeAbstract: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 12 mL/kg for the colloids and of 48 mL/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 ± 3 mL/kg. In the slow and the fast Infusion groups, it was 38.9 ± 4.3 and 32.6 ± 4.2 mL/kg for albumin (p < 0.001), 32.9 ± 4.3 and 29.5 ± 4.4 mL/kg for hydroxyethyl starch 130/0.4 (p < 0.05), 31.8 ± 3.9 and 28.2 ± 4.1 mL/kg for gelatin (p < 0.05), and 31.8 ± 5.3 and 30.7 ± 6.6 mL/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. (Less)
Per-olof Grände - One of the best experts on this subject based on the ideXlab platform.
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Infusion Rate and plasma volume expansion of dextran and albumin in the septic guinea pig.
Acta Anaesthesiologica Scandinavica, 2013Co-Authors: Björn P. Bark, Per-olof GrändeAbstract:Intravenous fluid treatment of hypovolaemia in states of increased capillary permeability, e.g. sepsis, is often accompanied by adverse oedema formation. A challenge is therefore to achieve and maintain normovolaemia using as little plasma volume substitution as possible to minimise interstitial oedema. In the present study, we evaluated the importance of Infusion Rate for the plasma volume expanding effects of 6% dextran 70 and 5% human albumin in a guinea pig sepsis model.
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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
Critical Care Medicine, 2013Co-Authors: Björn P. Bark, Johan Persson, Per-olof GrändeAbstract: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 12 mL/kg for the colloids and of 48 mL/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 ± 3 mL/kg. In the slow and the fast Infusion groups, it was 38.9 ± 4.3 and 32.6 ± 4.2 mL/kg for albumin (p < 0.001), 32.9 ± 4.3 and 29.5 ± 4.4 mL/kg for hydroxyethyl starch 130/0.4 (p < 0.05), 31.8 ± 3.9 and 28.2 ± 4.1 mL/kg for gelatin (p < 0.05), and 31.8 ± 5.3 and 30.7 ± 6.6 mL/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. (Less)
Peter Bentzer - One of the best experts on this subject based on the ideXlab platform.
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albumin Infusion Rate and plasma volume expansion a randomized clinical trial in postoperative patients after major surgery
Critical Care, 2019Co-Authors: Svajunas Statkevicius, Björn P. Bark, Johan Bonnevier, Jane Fisher, Erik Larsson, Carl M Oberg, Paivi Kannisto, Bobby Tingstedt, Peter BentzerAbstract:Optimal Infusion Rate of colloids in patients with suspected hypovolemia is unknown, and the primary objective of the present study was to test if plasma volume expansion by 5% albumin is greater if fluid is administered slowly rather than rapidly. Patients with signs of hypoperfusion after major abdominal surgery were randomized to intravenous Infusion of 5% albumin at a dose of 10 ml/kg (ideal body weight) either rapidly (30 min) or slowly (180 min). Plasma volume was measured using radiolabeled albumin at baseline, at 30 min, and at 180 min after the start of Infusion. Primary outcome was change in plasma volume from the start of Infusion to 180 min after the start of Infusion. Secondary outcomes included the change in the area under the plasma volume curve and transcapillary escape Rate (TER) for albumin from 180 to 240 min after the start of albumin Infusion. A total of 33 and 31 patients were included in the analysis in the slow and rapid groups, respectively. The change in plasma volume from the start of Infusion to 180 min did not differ between the slow and rapid Infusion groups (7.4 ± 2.6 vs. 6.5 ± 4.1 ml/kg; absolute difference, 0.9 ml/kg [95%CI, − 0.8 to 2.6], P = 0.301). Change in the area under the plasma volume curve was smaller in the slow than in the rapid Infusion group and was 866 ± 341 and 1226 ± 419 min ml/kg, respectively, P < 0.001. TER for albumin did not differ and was 5.3 ± 3.1%/h and 5.4 ± 3%/h in the slow and in the rapid Infusion groups, respectively, P = 0.931. This study does not support our hypothesis that a slow Infusion of colloid results in a greater plasma volume expansion than a rapid Infusion. Instead, our result of a smaller change in the area under the plasma volume curve indicates that a slow Infusion results in a less efficient plasma volume expansion, but further studies are required to confirm this finding. A rapid Infusion has no effect on vascular leak as measured after completion of the Infusion. EudraCT2013-004446-42 registered December 23, 2014.
Stig Haunso - One of the best experts on this subject based on the ideXlab platform.
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temperature controlled irrigated tip radiofrequency catheter ablation comparison of in vivo and in vitro lesion dimensions for standard catheter and irrigated tip catheter with minimal Infusion Rate
Journal of Cardiovascular Electrophysiology, 1998Co-Authors: Helen Hogh Petersen, Xu Chen, Adrian Pietersen, Jesper Hastrup Svendsen, Stig HaunsoAbstract:Temperature-Controlled Irrigated Tip Ablation. Introduction: In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures < 60% partly due to the limited lesion size after conventional radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high Infusion Rates enlarges lesion size, hut has increased risk of cRatering. The present study explores irrigated tip catheter ablation in temperature- controlled mode, target temperature 60°C, using an irrigation Rate of 1 mL/min, comparing this to conventional catheter technique, target temperature 80°C. Methods and Results: In vivo anesthetized pigs were ablated in the left ventricle. In vitro strips of porcine left ventricular myocardium were ablated in a tissue bath. Lesion volume was significantly larger after irrigated tip ablation both in vivo (544 ± 218 vs 325 ± 194 mm3, P < 0.01) and in vitro (286 ± 113 vs 179 ± 23 mm3, P < 0.01). The incidence of cRatering was not significantly different between the two groups. In vivo, no coagulum formation on part of the catheter tip was seen after irrigated tip ablation as opposed to 52% of the applications with conventional ablation (P < 0.05). Conclusion: We conclude that temperature-controlled radiofrequency ablation with irrigated tip catheters using low target temperature and low Infusion Rate enlarges lesion size without increasing the incidence of cRatering and reduces coagulum formation of the tip.
Svajunas Statkevicius - One of the best experts on this subject based on the ideXlab platform.
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albumin Infusion Rate and plasma volume expansion a randomized clinical trial in postoperative patients after major surgery
Critical Care, 2019Co-Authors: Svajunas Statkevicius, Björn P. Bark, Johan Bonnevier, Jane Fisher, Erik Larsson, Carl M Oberg, Paivi Kannisto, Bobby Tingstedt, Peter BentzerAbstract:Optimal Infusion Rate of colloids in patients with suspected hypovolemia is unknown, and the primary objective of the present study was to test if plasma volume expansion by 5% albumin is greater if fluid is administered slowly rather than rapidly. Patients with signs of hypoperfusion after major abdominal surgery were randomized to intravenous Infusion of 5% albumin at a dose of 10 ml/kg (ideal body weight) either rapidly (30 min) or slowly (180 min). Plasma volume was measured using radiolabeled albumin at baseline, at 30 min, and at 180 min after the start of Infusion. Primary outcome was change in plasma volume from the start of Infusion to 180 min after the start of Infusion. Secondary outcomes included the change in the area under the plasma volume curve and transcapillary escape Rate (TER) for albumin from 180 to 240 min after the start of albumin Infusion. A total of 33 and 31 patients were included in the analysis in the slow and rapid groups, respectively. The change in plasma volume from the start of Infusion to 180 min did not differ between the slow and rapid Infusion groups (7.4 ± 2.6 vs. 6.5 ± 4.1 ml/kg; absolute difference, 0.9 ml/kg [95%CI, − 0.8 to 2.6], P = 0.301). Change in the area under the plasma volume curve was smaller in the slow than in the rapid Infusion group and was 866 ± 341 and 1226 ± 419 min ml/kg, respectively, P < 0.001. TER for albumin did not differ and was 5.3 ± 3.1%/h and 5.4 ± 3%/h in the slow and in the rapid Infusion groups, respectively, P = 0.931. This study does not support our hypothesis that a slow Infusion of colloid results in a greater plasma volume expansion than a rapid Infusion. Instead, our result of a smaller change in the area under the plasma volume curve indicates that a slow Infusion results in a less efficient plasma volume expansion, but further studies are required to confirm this finding. A rapid Infusion has no effect on vascular leak as measured after completion of the Infusion. EudraCT2013-004446-42 registered December 23, 2014.