The promise of next generation colloids

Ben C Creagh-Brown,Timothy W Evans

doi:10.1186/cc6892

Abstract

The aim of perioperative haemodilution is to reduce loss of red blood cells during elective surgery. The oncotic and molecular characteristics of the various plasma substitutes employed determine how effectively normovolaemia is maintained, and their non-oncotic effects include alterations in microvascular perfusion. In the previous issue of Critical Care, Martini and colleagues assessed the effects of haemodilution with either polyethylene glycol (PEG)ylated albumin or a commercially available hydroxyethyl starch-based colloid in a hamster haemorrhage model. PEGylated albumin was superior to hydroxyethyl starch, as reflected by survival, haemodynamic parameters and assessment of the microcirculation using intravital microscopy.

Highlights

In the previous issue of Critical Care, Martini and colleagues [1] assessed the effects of haemodilution with either polyethylene glycol (PEG)ylated albumin or a commercially available hydroxyethyl starch-based colloid in a hamster haemorrhage model
From baseline the PEG-albumin group had a lower haematocrit, implying that more of the study solution remained within the vascular compartment
Significantly more arteriolar and venular constriction was detectable during haemorrhage in the hydroxyethyl starch (HES) group

Summary

Introduction

In the previous issue of Critical Care, Martini and colleagues [1] assessed the effects of haemodilution with either polyethylene glycol (PEG)ylated albumin or a commercially available hydroxyethyl starch-based colloid in a hamster haemorrhage model. The aim of perioperative haemodilution, termed acute normovolaemic hemodilution (ANH), is to reduce loss of red blood cells during elective surgery. Martini and colleagues [1] explored these effects further by examining the consequences of slow replacement of 50% of the circulating volume in hamsters with either PEGylated albumin or a commercially available hydroxyethyl starch (HES)based colloid, namely Voluven® (Fresenius Kabi, Austria), followed by removal of 60% of circulating volume over 1 hour.

Results

Conclusion