Stable Plasma Protein Solution Research Articles

Diabetic ketoacidosis and clozapine.

1 Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 1977;1:466-9. 2 Laxenaire MC, Charpentier C, Feldman L. [Anaphylactoid reactions to colloid plasma substitutes:...

The concomitant use of stable plasma protein solution (SPPS) should be avoided

The concomitant use of stable plasma protein solution (SPPS) should be avoided

Hypernatraemic dehydration after Lucozade

To emphasise the dangers of inappropriate rehydration fluids in the treatment of gastroenteritis. A two-year-old girl was admitted to hospital in shock and unconscious. She had a 36-hour history of diarrhoeal illness and had received Lucozade. Therapy with this hypertonic fluid resulted in worsening diarrhoea and seizures. On examination she had hypernatraemic dehydration and decorticate posturing. An intravenous line was inserted, stable plasma protein solution was given, and she was admitted to the intensive care unit. Anticonvulsant and antibiotic therapy were begun. Significant neurological impairment was still evident after 14 days, at which time shw was discharged from hospital. Six months later she had made a good recovery, with no persisting neurological deficit. The inappropriate use of hypertonic fluids in gastroenteritis may be associated with significant electrolyte imbalances and neurological sequelae.

Human albumin solutions: an audit of use in three major metropolitan hospitals: Subcommittee of the Victorian Drug Usage Advisory Committee

To evaluate the volume used and the indications for use of the human albumin solutions, stable plasma protein solution and normal serum albumin, in Victorian metropolitan teaching hospitals. The Victorian Drug Usage Advisory Committee conducted a prospective audit by means of a questionnaire in three major Melbourne teaching hospitals over a three-month period. All bottles of the human albumin solutions issued were numbered and a questionnaire regarding indications for use was completed for each patient treated with either product. The results were compared with the recommendations of the Australasian Society of Blood Transfusion to determine whether usage was appropriate, and the number of bottles used was analysed for each hospital and each major indication. The survey was comprehensive (84% of the forms were returned) and demonstrated that these products are used for appropriate clinical categories, for example, hypovolaemia, hypoalbuminaemia, and not for inappropriate indications, such as nutritional support or wound healing. There was however a marked variation in the level of usage for a given indication between the three hospitals. This variation reflected a considerable difference in unit policy regarding the use of these products in preference to crystalloid or synthetic colloid solutions. The variation suggests the need for more specific guidelines for the use of these products in defined clinical settings.

Possible Interaction between SPPS and Enalapril

A patient undergoing groin lymph node dissection with spinal and general anaesthesia was receiving enalapril to control hypertension. Infusion of stable plasma protein solution (Commonwealth Serum Laboratories, Australia) was associated with significant hypotension and flushing. A brief review of stable plasma protein solution and angiotensin converting enzyme inhibitor pharmacology is presented to provide a possible mechanism for these events. This mechanism implies that angiotensin converting enzyme inhibitor therapy is a relative contraindication to rapid SPPS infusion.

Stable plasma protein solution

Modern preparation methods reduce risk of untoward reactions

Temperature sensitivity within the pasteurization temperature range of prekallikrein activator in stable plasma protein solution (SPPS).

Human plasma protein fraction, used worldwide as a plasma expander, produces in some recipients adverse reactions resembling those following infusion of bradykinin. The presence of excessive quantities of a Hageman factor degradation product (prekallikrein activator, PKA) in the protein solution is thought to be the reason for these reactions. Like other manufacturers, CSL has experienced batch‐to‐batch variability in the PKA levels in its plasma protein product (SPPS). In this paper, data is presented showing that PKA is inactivated to a greater extent at the high extreme (60.5 C) of the pasteurization temperature range than at the low extreme (59.5 C). This difference in pasteurization temperature can lead to a two‐ or threefold difference in PKA concentration in the final product and can make the difference between the product being potentially reactive or innocuous, as well as accounting for some of the batch‐to‐batch variability observed in the past.

Inhibition of the hypotensive effect of plasma protein solutions by C1esterase inhibitor

The hypotensive effect of stable plasma protein solution (SPPS) is a well-known phenomenon, causing serious problems in surgical patients and patients supported by cardiopulmonary bypass. Kinins are believed to be responsible. A study was made to prevent this hypotension by adding C1 esterase inhibitor to the SPPS and comparing this with 5% human albumin. The results shows a significant difference between the effects of SPPS and SPPS plus C1 esterase inhibitor infusion on bypass. Five percent human albumin did not cause hypotension. Possible sequelae are discussed.

Venoconstrictor activity of some precursor fractions of stable plasma protein solution.

Stable plasma protein solution (SPPS) is a 5% solution of human plasma albumin and some globulins. Rapid infusion of some batches of SPPS and analogous solutions prepared by similar processes induce paradoxical hypotensive reactions. In the current experiments, a number of precursor fractions of a single batch of SPPS were examined for kininogen content and for venoconstrictor activity on the isolated central vein of the rabbit ear. Unheated SPPS contained both venoconstrictor activity and kininogen. Among the various precursor fractions examined, Cohn fraction II + III (a precursor of fraction III-0) contained the greatest venoconstrictor activity. There was no evidence of kininogen depletion during the stages of fractionation examined but some generation of venoconstrictor material. Column chromatography suggested a molecular weight of approximately 1,500 for the major active material in unheated SPPS. It appears possible that the 14-amino acid hypotensive peptide present in fraction III-0 may also be present in SPPS, where it may contribute to the hypotensive effects of this solution.

STABLE PLASMA PROTEIN SOLUTION (SPPS) AND MYOCARDIAL INFARCTION

Medical Journal of AustraliaVolume 1, Issue 5 p. 239-239 Correspondence STABLE PLASMA PROTEIN SOLUTION (SPPS) AND MYOCARDIAL INFARCTION Jeffrey R. Eisman, Jeffrey R. Eisman 20 President Avenue, Caringbah, N.S.W. 2229Search for more papers by this author Jeffrey R. Eisman, Jeffrey R. Eisman 20 President Avenue, Caringbah, N.S.W. 2229Search for more papers by this author First published: March 1980 https://doi.org/10.5694/j.1326-5377.1980.tb134800.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue5March 1980Pages 239-239 RelatedInformation

Reactions to Rapid Infusion of Stable Plasma Protein Solution during Large Volume Plasma Exchange

Five per cent heat treated stable plasma protein solution (SPPS) has been rapidly infused into 25 patients, as fluid replacement during large volume plasmapheresis. Reactions were produced in 20 patients. Subjective symptoms of flushing, nasal stuffiness, fullness and throbbing in the head, colicky abdominal pain, metallic taste or apprehension were observed in 16 patients, and 11 patients became hypotensive with an average systolic pressure of 70 mm Hg. These observations support earlier reports of hypotension due to rapid SPPS infusion, and document the occurrence of subjective symptoms which may be the harbingers of a hypotensive reaction. In view of the known presence of a bradykinin-like substance in some heat treated plasma protein solutions, hypotension during SPPS infusion should be interpreted with caution in the light of these findings.

Comparative Effects of Dextrans, Gelatin and Stable Plasma Protein Solution (SPPS) on the Experimental Disseminated Intravascular Coagulation (DIC)

In an experimental study on the rabbit (80 animals) the haemostasis changes observed during the perfusion of dextrans of various molecular weights, gelatin and stable plasma protein solution (1.5 g/kg/h during 3 h) are compared using the normal animal and the animal with DIC induced by thrombin perfusion (100 U/kg/h during 3 h). With the normal animal, no significant disorders of haemostasis have been observed during perfusion of dextran 40 or SPPS. On the contrary, the perfusions with dextran 75 or gelatin are associated with modifications of platelet activities and of platelet and plasma plasmininhibiting activities similar to those found in thrombophilia states. Perfusion with dextran 200 produces haemostasis changes similar to those found during consumptive coagulopathies. In the animals with DIC, preventive, simultaneous or curative administration of dextrans 40, 75, 200 or gelatin significantly enhances the haemostasis disorders produced by perfusion with thrombin alone, this is opposed to SPPS which has no influence.

Hypotensive effects of stable plasma protein solution (SPPS): a preliminary communication.

Medical Journal of AustraliaVolume 2, Issue 25 p. 1308-1309 Correspondence HYPOTENSIVE EFFECTS OF STABLE PLASMA PROTEIN SOLUTION (SPPS): A PRELIMINARY COMMUNICATION First published: 01 December 1971 https://doi.org/10.5694/j.1326-5377.1971.tb92856.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume2, Issue25December 1971Pages 1308-1309 RelatedInformation

Hypotensive effects of stable plasma protein solution (SPPS): a preliminary communication.

Medical Journal of AustraliaVolume 2, Issue 20 p. 1040-1041 Correspondence HYPOTENSIVE EFFECTS OF STABLE PLASMA PROTEIN SOLUTION (SPPS): A PRELIMINARY COMMUNICATION First published: 01 November 1971 https://doi.org/10.5694/j.1326-5377.1971.tb92692.xCitations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume2, Issue20November 1971Pages 1040-1041 RelatedInformation

The use of natural and artificial plasma volume expanders and the wet-lung syndrome.

The use of 1 to 2 I. of lactated Ringer's solution or Isotonic saline solution, followed by 0·5 to 1 I. of stable plasma protein solution (SPPS), as plasma volume expanders is advocated for initial resuscitation, before blood is used, in the treatment of the majority of patients suffering from acute blood loss sufficient to produce shock if untreated. This therapeutic regimen minimizes the risk of occurrence of the wet-lung syndrome arising from either hypovolæmia or acute hypoproteinæmia and, by frequently avoiding the need for blood, diminishes the frequency of exposure to the hazards which accompany the transfusion of human blood cellular elements.

Generation and survival of angiotensin in nonrefrigerated plasma. An explanation for presence of pressor material in human plasma protein solutions used clinically.

In a previous report a pressor agent was described in a human stable plasma protein solution (SPPS) used clinically as a volume expander, 12 and evidence was presented that this agent was angiotensin. SPPS is prepared by Commonwealth Serum Laboratories (Melbourne) from the plasma fraction of out‐dated donor blood (Red Cross Blood Banks). This plasma is transported to Melbourne from centers up to 2,000 miles away, a proportion of it reaching ambient temperature prior to arrival. Cold ethanol fractionation to yield the albumin fraction is followed by heating for 10 hours at 60 C. The levels of renin, rerun substrate, angiotensin and angiotensinase activity were measured in donor plasma held at 4 C, plasma pool (after transport to Melbourne), and in the SPPS fraction before and after heat treatment. Results suggest that angiotensin is generated in the plasma pools while at ambient temperature. The generated angiotensin is relatively resistant to destruction by endogenous angiotensinases in plasma (in vitro) when compared with angiotensin‐II‐amide (Hypertensin, Ciba). The presence of concentrations of angiotensin sufficient to affect the blood pressure and aldosterone secretion of human recipients should be suspected in plasma (or plasma products) the preparation of which includes a period at ambient or higher temperature.

A Pressor Agent in Human Stable Plasma Protein Solutions

A pressor material in human stable plasma protein solutions is described, and evidence that this material may be angiotensin II is presented. When six samples of stable plasma protein solution were assayed against standard angiotensin in the sensitive, ganglioplegic, nephrectomized rat anesthetized with urethane, the levels of pressor activity ranged from 320 to 830 ng/100 ml, with a mean of 552 ng/100 ml. The solution gives a pressor response similar to that of angiotensin II, is heat stable, dialyzable, and destroyed by trypsin and α-chymotrypsin, and reacts with the antibody in a radio-immunoassay for angiotensin II. It is present in sufficient concentration to have significant effects on blood pressure, renal handling of sodium, and aldosterone secretion when infused into patients at rates commonly employed.

Measurement of cardiac output by thermal dilution in man.

Measurement of cardiac output by thermal dilution in man.

Preparation and properties of a stable human plasma protein solution.

SummaryThe preparation of a heat‐stable human plasma protein solution by the ethanol fractionation method at low temperatures is described.The effect of heating for 10 hours at 60° C. on some properties of this protein solution has been investigated.RésuméLa préparation d'une solution de protéines plasmatiques humaines thermostabile par la méthode de fractionnement à l'éthanol à basse température est décrite, et le comportement de certaines propriétés de cette solution lorsqu'elle est chauffée à 60° C pendant 10 heures a été étudié.ZusammenfassungDie Herstellung einer wärmestabilen Plasmaproteinlosung wird beschrieben. Sie beruht auf einer Modifikation der Alkoholfraktionierungsmethode bei niedrigen Temperaturen. Der Einfluß der zehnstündigen Wärmebehandlung bei 60° C auf die Eiweiße dieser Lösung wurde untersucht.

Preparation and Properties of a Stable Human Plasma Protein Solution

Of all the methods proposed for the inactivation of the virus of homologous serum hepatitis, only heating for 10 hours at 60° C. has been shown to be reliable. Several publications have dealt with methods of modifying plasma in order to make it heat-stable (Surgenor [10], Nitschmann [7, 8], Mulford [5, 6]). The separation of the heat-labile plasma protein fractions in such a form as will be clinically useful is possible by the use of ethanol-water mixtures at low temperatures (Cohn [2]), and Mulford used this method in part to obtain a heat-stable plasma- protein solution. The purpose of the present communication is to give a survey of the authors’ experiences since January 1956 in the preparation of a heat-stable human plasma protein solution obtained by a modification of the ethanol-fractionation method used in this Laboratory since 1947, which is based upon the use of citric acid, sodium hydroxyde and ethanol only. This method has simplified to a great extent the original method of Cohn et al.