Comparison of crystalloids and colloids for hemodilution in a model of focal cerebral ischemia

K. Korosue, R. C. Heros, C. S. Ogilvy, A. Hyodo, Y. K. Tu, R. Graichen

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Forty dogs were subjected to 6 hours of occlusion of the left internal carotid and middle cerebral arteries. They were divided into two 'hemodilution groups' of 13 dogs each and a control 'nonhemodiluted group' of 14 dogs. Thirty minutes after arterial occlusion, isovolemic hemodilution was performed by phlebotomy and infusions of low-molecular weight (MW) dextran in one group and of lactated Ringer's solution in the other group. The animals were sacrificed 1 week after temporary arterial occlusion. Hemodilution reduced the hematocrit to a level of 33% to 34%, which lasted throughout the week in both groups. After hemodilution there was a very significant reduction in blood viscosity, plasma total protein content, and fibrinogen levels in both groups in the acute stage; these levels gradually returned to baseline by the end of the week. In the group with lactated Ringer's solution hemodilution, both osmotic and oncotic pressures were decreased by hemodilution in the acute stage. In the control and low-MW dextran groups, osmotic and oncotic pressure remained unaltered throughout the week. Hemodilution resulted in a slight decrease in mean arterial blood pressure in all groups in the acute stage, but there were no significant changes in central venous, pulmonary arterial, or pulmonary wedge pressures. During the week of study, there were no differences in the cardiac index and total blood volume between the groups, and no significant changes in hematological parameters with the exception of a slight increase in bleeding time immediately after hemodilution with low-MW dextran. Daily neurological assessment showed consistently poorer condition during the first 5 days in the group with lactated Ringer's solution compared to either the control group or the group receiving low-MW dextran. Based on Mann-Whitney U-testing, the infarct volume of the lactated Ringer's solution recipients, expressed as a percentage of the total volume of that hemisphere (median 15.7%, range 6.6% to 25.2%) was significantly larger than that of the group receiving low-MW dextran (median 2.2%, range 0% to 15.8%) and that of the control group (median 11.9%, range 0% to 39.9%). The results indicate that, in this model, hemodilution with colloids was beneficial, whereas hemodilution with crystalloids was deleterious. It is likely that the decrease in oncotic pressure observed after hemodilution with lactated Ringer's solution is one of the most important reasons for its detrimental effect.

Original languageEnglish
Pages (from-to)576-584
Number of pages9
JournalJournal of Neurosurgery
Volume73
Issue number4
DOIs
Publication statusPublished - Jan 1 1990
Externally publishedYes

Fingerprint

Hemodilution
Colloids
Brain Ischemia
Dextrans
Molecular Weight
Osmotic Pressure
Dogs
Control Groups
Arterial Pressure
crystalloid solutions
Blood Viscosity
Bleeding Time
Pulmonary Wedge Pressure
Phlebotomy
Middle Cerebral Artery
Blood Volume
Hematocrit
Fibrinogen
Blood Proteins
Ringer's solution

Keywords

  • colloid solution
  • crystalloid solution
  • edema
  • hemodilution
  • infarction

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Comparison of crystalloids and colloids for hemodilution in a model of focal cerebral ischemia. / Korosue, K.; Heros, R. C.; Ogilvy, C. S.; Hyodo, A.; Tu, Y. K.; Graichen, R.

In: Journal of Neurosurgery, Vol. 73, No. 4, 01.01.1990, p. 576-584.

Research output: Contribution to journalArticle

Korosue, K. ; Heros, R. C. ; Ogilvy, C. S. ; Hyodo, A. ; Tu, Y. K. ; Graichen, R. / Comparison of crystalloids and colloids for hemodilution in a model of focal cerebral ischemia. In: Journal of Neurosurgery. 1990 ; Vol. 73, No. 4. pp. 576-584.
@article{6793d5c601ee4072a9f99dfd56c6b6cd,
title = "Comparison of crystalloids and colloids for hemodilution in a model of focal cerebral ischemia",
abstract = "Forty dogs were subjected to 6 hours of occlusion of the left internal carotid and middle cerebral arteries. They were divided into two 'hemodilution groups' of 13 dogs each and a control 'nonhemodiluted group' of 14 dogs. Thirty minutes after arterial occlusion, isovolemic hemodilution was performed by phlebotomy and infusions of low-molecular weight (MW) dextran in one group and of lactated Ringer's solution in the other group. The animals were sacrificed 1 week after temporary arterial occlusion. Hemodilution reduced the hematocrit to a level of 33{\%} to 34{\%}, which lasted throughout the week in both groups. After hemodilution there was a very significant reduction in blood viscosity, plasma total protein content, and fibrinogen levels in both groups in the acute stage; these levels gradually returned to baseline by the end of the week. In the group with lactated Ringer's solution hemodilution, both osmotic and oncotic pressures were decreased by hemodilution in the acute stage. In the control and low-MW dextran groups, osmotic and oncotic pressure remained unaltered throughout the week. Hemodilution resulted in a slight decrease in mean arterial blood pressure in all groups in the acute stage, but there were no significant changes in central venous, pulmonary arterial, or pulmonary wedge pressures. During the week of study, there were no differences in the cardiac index and total blood volume between the groups, and no significant changes in hematological parameters with the exception of a slight increase in bleeding time immediately after hemodilution with low-MW dextran. Daily neurological assessment showed consistently poorer condition during the first 5 days in the group with lactated Ringer's solution compared to either the control group or the group receiving low-MW dextran. Based on Mann-Whitney U-testing, the infarct volume of the lactated Ringer's solution recipients, expressed as a percentage of the total volume of that hemisphere (median 15.7{\%}, range 6.6{\%} to 25.2{\%}) was significantly larger than that of the group receiving low-MW dextran (median 2.2{\%}, range 0{\%} to 15.8{\%}) and that of the control group (median 11.9{\%}, range 0{\%} to 39.9{\%}). The results indicate that, in this model, hemodilution with colloids was beneficial, whereas hemodilution with crystalloids was deleterious. It is likely that the decrease in oncotic pressure observed after hemodilution with lactated Ringer's solution is one of the most important reasons for its detrimental effect.",
keywords = "colloid solution, crystalloid solution, edema, hemodilution, infarction",
author = "K. Korosue and Heros, {R. C.} and Ogilvy, {C. S.} and A. Hyodo and Tu, {Y. K.} and R. Graichen",
year = "1990",
month = "1",
day = "1",
doi = "10.3171/jns.1990.73.4.0576",
language = "English",
volume = "73",
pages = "576--584",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "4",

}

TY - JOUR

T1 - Comparison of crystalloids and colloids for hemodilution in a model of focal cerebral ischemia

AU - Korosue, K.

AU - Heros, R. C.

AU - Ogilvy, C. S.

AU - Hyodo, A.

AU - Tu, Y. K.

AU - Graichen, R.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - Forty dogs were subjected to 6 hours of occlusion of the left internal carotid and middle cerebral arteries. They were divided into two 'hemodilution groups' of 13 dogs each and a control 'nonhemodiluted group' of 14 dogs. Thirty minutes after arterial occlusion, isovolemic hemodilution was performed by phlebotomy and infusions of low-molecular weight (MW) dextran in one group and of lactated Ringer's solution in the other group. The animals were sacrificed 1 week after temporary arterial occlusion. Hemodilution reduced the hematocrit to a level of 33% to 34%, which lasted throughout the week in both groups. After hemodilution there was a very significant reduction in blood viscosity, plasma total protein content, and fibrinogen levels in both groups in the acute stage; these levels gradually returned to baseline by the end of the week. In the group with lactated Ringer's solution hemodilution, both osmotic and oncotic pressures were decreased by hemodilution in the acute stage. In the control and low-MW dextran groups, osmotic and oncotic pressure remained unaltered throughout the week. Hemodilution resulted in a slight decrease in mean arterial blood pressure in all groups in the acute stage, but there were no significant changes in central venous, pulmonary arterial, or pulmonary wedge pressures. During the week of study, there were no differences in the cardiac index and total blood volume between the groups, and no significant changes in hematological parameters with the exception of a slight increase in bleeding time immediately after hemodilution with low-MW dextran. Daily neurological assessment showed consistently poorer condition during the first 5 days in the group with lactated Ringer's solution compared to either the control group or the group receiving low-MW dextran. Based on Mann-Whitney U-testing, the infarct volume of the lactated Ringer's solution recipients, expressed as a percentage of the total volume of that hemisphere (median 15.7%, range 6.6% to 25.2%) was significantly larger than that of the group receiving low-MW dextran (median 2.2%, range 0% to 15.8%) and that of the control group (median 11.9%, range 0% to 39.9%). The results indicate that, in this model, hemodilution with colloids was beneficial, whereas hemodilution with crystalloids was deleterious. It is likely that the decrease in oncotic pressure observed after hemodilution with lactated Ringer's solution is one of the most important reasons for its detrimental effect.

AB - Forty dogs were subjected to 6 hours of occlusion of the left internal carotid and middle cerebral arteries. They were divided into two 'hemodilution groups' of 13 dogs each and a control 'nonhemodiluted group' of 14 dogs. Thirty minutes after arterial occlusion, isovolemic hemodilution was performed by phlebotomy and infusions of low-molecular weight (MW) dextran in one group and of lactated Ringer's solution in the other group. The animals were sacrificed 1 week after temporary arterial occlusion. Hemodilution reduced the hematocrit to a level of 33% to 34%, which lasted throughout the week in both groups. After hemodilution there was a very significant reduction in blood viscosity, plasma total protein content, and fibrinogen levels in both groups in the acute stage; these levels gradually returned to baseline by the end of the week. In the group with lactated Ringer's solution hemodilution, both osmotic and oncotic pressures were decreased by hemodilution in the acute stage. In the control and low-MW dextran groups, osmotic and oncotic pressure remained unaltered throughout the week. Hemodilution resulted in a slight decrease in mean arterial blood pressure in all groups in the acute stage, but there were no significant changes in central venous, pulmonary arterial, or pulmonary wedge pressures. During the week of study, there were no differences in the cardiac index and total blood volume between the groups, and no significant changes in hematological parameters with the exception of a slight increase in bleeding time immediately after hemodilution with low-MW dextran. Daily neurological assessment showed consistently poorer condition during the first 5 days in the group with lactated Ringer's solution compared to either the control group or the group receiving low-MW dextran. Based on Mann-Whitney U-testing, the infarct volume of the lactated Ringer's solution recipients, expressed as a percentage of the total volume of that hemisphere (median 15.7%, range 6.6% to 25.2%) was significantly larger than that of the group receiving low-MW dextran (median 2.2%, range 0% to 15.8%) and that of the control group (median 11.9%, range 0% to 39.9%). The results indicate that, in this model, hemodilution with colloids was beneficial, whereas hemodilution with crystalloids was deleterious. It is likely that the decrease in oncotic pressure observed after hemodilution with lactated Ringer's solution is one of the most important reasons for its detrimental effect.

KW - colloid solution

KW - crystalloid solution

KW - edema

KW - hemodilution

KW - infarction

UR - http://www.scopus.com/inward/record.url?scp=0025112827&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025112827&partnerID=8YFLogxK

U2 - 10.3171/jns.1990.73.4.0576

DO - 10.3171/jns.1990.73.4.0576

M3 - Article

C2 - 1697903

AN - SCOPUS:0025112827

VL - 73

SP - 576

EP - 584

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 4

ER -