This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by McIlroy, D. R. Articles by Kharasch, E. D. Search for Related Content PubMed PubMed Citation Articles by McIlroy, D. R. Articles by Kharasch, E. D. Related Collections Blood Resuscitation

---

CARDIOVASCULAR ANESTHESIA

Acute Intravascular Volume Expansion with Rapidly Administered Crystalloid or Colloid in the Setting of Moderate Hypovolemia

Department of Anesthesiology, University of Washington Medical Center, Seattle

Address correspondence and reprint requests to David McIlroy, Department of Anesthesia and Pain Management, Alfred Hospital, Commercial Rd., Melbourne 3004, Victoria, Australia. Address e-mail to d.mcilroy{at}alfred.org.au

Although the distribution of various crystalloid and colloid solutions at equilibrium has been well established, the acute peak expansion of intravascular volume that can be achieved with the rapid administration of crystalloid or colloid is unknown. We studied eight healthy male subjects in a two-part crossover trial designed to assess the maximal increase in intravascular volume achieved with 1000 mL of lactated Ringer’s solution compared with the same volume of 6% Hetastarch. Subjects were made moderately hypovolemic by the withdrawal of 900 mL of blood, and then the crystalloid or colloid solution was rapidly infused over 5–7 min. Serial dilution of hematocrit was measured every 5 min for 30 min to determine changes in blood volume. Peak expansion of intravascular volume with lactated Ringer’s solution was 630 ± 127 mL, occurring immediately the rapid infusion was complete, whereas the peak expansion of intravascular volume with 6% Hetastarch was 1123 ± 116 mL and occurred 5 min after the completion of the fluid infusion. The results were significantly different (P < 0.001). These results would suggest that even for very short periods of time, rapid infusion of colloid significantly more effectively increases blood volume and, by inference, cardiac output than the same volume of crystalloid, even if the crystalloid is administered very rapidly.

IMPLICATIONS: Under conditions of moderate hypovolemia, the maximal acute intravascular volume expansion with the rapid infusion of 1000 mL of lactated Ringer’s solution is slightly more than half that achieved with the same volume of 6% Hetastarch.

This article has been cited by other articles:

				C. H. Svensen, P. M. Rodhe, J. Olsson, E. Borsheim, A. Aarsland, and R. G. Hahn Arteriovenous Differences in Plasma Dilution and the Distribution Kinetics of Lactated Ringer's Solution Anesth. Analg., January 1, 2009; 108(1): 128 - 133. [Abstract] [Full Text] [PDF]

				T. Tatara, T. Tsunetoh, and C. Tashiro Crystalloid infusion rate during fluid resuscitation from acute haemorrhage Br. J. Anaesth., August 1, 2007; 99(2): 212 - 217. [Abstract] [Full Text] [PDF]

				C. Charron, C. Fessenmeyer, C. Cosson, J.-X. Mazoit, J.-L. Hebert, D. Benhamou, and A. R. Edouard The Influence of Tidal Volume on the Dynamic Variables of Fluid Responsiveness in Critically Ill Patients. Anesth. Analg., May 1, 2006; 102(5): 1511 - 1517. [Abstract] [Full Text] [PDF]

				P. J. Van der Linden, S. G. De Hert, D. Deraedt, S. Cromheecke, K. De Decker, R. D. Paep, I. Rodrigus, A. Daper, and A. Trenchant Hydroxyethyl Starch 130/0.4 Versus Modified Fluid Gelatin for Volume Expansion in Cardiac Surgery Patients: The Effects on Perioperative Bleeding and Transfusion Needs Anesth. Analg., September 1, 2005; 101(3): 629 - 634. [Abstract] [Full Text] [PDF]

				J. C. Drummond and C. T. Petrovitch Intraoperative Blood Salvage: Fluid Replacement Calculations Anesth. Analg., March 1, 2005; 100(3): 645 - 649. [Abstract] [Full Text] [PDF]