Crystalloid infusion increases plasma hyaluronan

Abstract

Objective: To investigate the changes in plasma hyaluronan concentrations after intravenous infusion of crystalloid solution in healthy subjects. Design: Crossover, controlled study. Setting: General intensive care unit in a university hospital. Subjects: Twelve healthy medical students. Interventions: Infusion of 1000 mL iv Ringer's acetate solution during a 40-min period. Measurements and Main Results: Plasma hyaluronan concentrations were measured before, during, and after infusion, and under the same conditions without the infusion in a separate session. Hemoglobin, hematocrit, and serum albumin concentrations were measured before and after infusion. Plasma volume at baseline and the volume of Ringer's acetate retained in the intravascular space after infusion were calculated. Plasma hyaluronan values increased from baseline mean of 12 ± 5.8 (SD) to 20 ± 13.1 μg/L (p<.01) at 30 mins and 25 ± 13.0 μg/L (p< .001) at 40 mins after start of the infusion. Plasma hyaluronan concentrations peaked at 10 mins after the end of the infusion: 27 ± 13.9 μg/L (p< .001). No changes in plasma hyaluronan concentrations were seen during the control period. A volume of 230 to 250 mL of Ringer's acetate solution was calculated to be retained within the intravascular space. Conclusions: Infusion of crystalloid solution increases plasma hyaluronan, probably through a washout of interstitial hyaluronan by way of increased lymph flow. The consequences of the interstitial loss of hyaluronan on tissue function are unknown. (Crit Care Med 1994; 22:1563–1567)