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Shin DY, Park JS, Lee HS, Shim W, Jin L, Lee KW, Park JB, Kim DH, Kim JH. The effect of hydroxyethyl starch as a cryopreservation agent during freezing of mouse pancreatic islets. Biochem Biophys Rep 2024; 38:101658. [PMID: 38362049 PMCID: PMC10867579 DOI: 10.1016/j.bbrep.2024.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
Islet transplantation is the most effective treatment strategy for type 1 diabetes. Long-term storage at ultralow temperatures can be used to prepare sufficient islets of good quality for transplantation. For freezing islets, dimethyl sulfoxide (DMSO) is a commonly used penetrating cryoprotective agent (CPA). However, the toxicity of DMSO is a major obstacle to cell cryopreservation. Hydroxyethyl starch (HES) has been proposed as an alternative CPA. To investigate the effects of two types of nonpermeating CPA, we compared 4 % HES 130 and HES 200 to 10 % DMSO in terms of mouse islet yield, viability, and glucose-stimulated insulin secretion (GSIS). After one day of culture, islets were cryopreserved in each solution. After three days of cryopreservation, islet recovery was significantly higher in the HES 130 and HES 200 groups than in the DMSO group. Islet viability in the HES 200 group was also significantly higher than that in the DMSO group on Day 1 and Day 3. Stimulation indices determined by GSIS were higher in the HES 130 and 200 groups than in the DMSO group on Day 3. After three days of cryopreservation, HES 130 and HES 200 both reduced the expression of apoptosis- and necrosis-associated proteins and promoted the survival of islets. In conclusion, the use of HES as a CPA improved the survival and insulin secretion of cryopreserved islets compared with the use of a conventional CPA.
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Affiliation(s)
- Du Yeon Shin
- Transplantation Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, 06351, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Graduate School, Sungkyunkwan University, Seoul, 06351, Republic of Korea
| | - Jae Suh Park
- Department of Pediatrics, Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Han-Sin Lee
- R&D Center, Cellstormer, Suwon-si, Gyeonggi-do, 16677, Republic of Korea
| | - Wooyoung Shim
- R&D Center, Cellstormer, Suwon-si, Gyeonggi-do, 16677, Republic of Korea
| | - Lauren Jin
- Department of Pediatrics, Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Kyo Won Lee
- Transplantation Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, 06351, Republic of Korea
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Jae Berm Park
- Transplantation Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, 06351, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Graduate School, Sungkyunkwan University, Seoul, 06351, Republic of Korea
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Dong Hyun Kim
- Department of Pediatrics, Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
| | - Jae Hyeon Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Graduate School, Sungkyunkwan University, Seoul, 06351, Republic of Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06355, Republic of Korea
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Behem CR, Friedheim T, Holthusen H, Rapp A, Suntrop T, Graessler MF, Pinnschmidt HO, Wipper SH, von Lucadou M, Schwedhelm E, Renné T, Pfister K, Schierling W, Trepte CJC. Goal-directed colloid versus crystalloid therapy and microcirculatory blood flow following ischemia/reperfusion. Microvasc Res 2024; 152:104630. [PMID: 38048876 DOI: 10.1016/j.mvr.2023.104630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/11/2023] [Accepted: 11/25/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Ischemia/reperfusion can impair microcirculatory blood flow. It remains unknown whether colloids are superior to crystalloids for restoration of microcirculatory blood flow during ischemia/reperfusion injury. We tested the hypothesis that goal-directed colloid - compared to crystalloid - therapy improves small intestinal, renal, and hepatic microcirculatory blood flow in pigs with ischemia/reperfusion injury. METHODS This was a randomized trial in 32 pigs. We induced ischemia/reperfusion by supra-celiac aortic-cross-clamping. Pigs were randomized to receive either goal-directed isooncotic hydroxyethyl-starch colloid or balanced isotonic crystalloid therapy. Microcirculatory blood flow was measured using Laser-Speckle-Contrast-Imaging. The primary outcome was small intestinal, renal, and hepatic microcirculatory blood flow 4.5 h after ischemia/reperfusion. Secondary outcomes included small intestinal, renal, and hepatic histopathological damage, macrohemodynamic and metabolic variables, as well as specific biomarkers of tissue injury, renal, and hepatic function and injury, and endothelial barrier function. RESULTS Small intestinal microcirculatory blood flow was higher in pigs assigned to isooncotic hydroxyethyl-starch colloid therapy than in pigs assigned to balanced isotonic crystalloid therapy (768.7 (677.2-860.1) vs. 595.6 (496.3-694.8) arbitrary units, p = .007). There were no important differences in renal (509.7 (427.2-592.1) vs. 442.1 (361.2-523.0) arbitrary units, p = .286) and hepatic (604.7 (507.7-701.8) vs. 548.7 (444.0-653.3) arbitrary units, p = .376) microcirculatory blood flow between groups. Pigs assigned to colloid - compared to crystalloid - therapy also had less small intestinal, but not renal and hepatic, histopathological damage. CONCLUSIONS Goal-directed isooncotic hydroxyethyl-starch colloid - compared to balanced isotonic crystalloid - therapy improved small intestinal, but not renal and hepatic, microcirculatory blood flow in pigs with ischemia/reperfusion injury. Whether colloid therapy improves small intestinal microcirculatory blood flow in patients with ischemia/reperfusion needs to be investigated in clinical trials.
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Affiliation(s)
- Christoph R Behem
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Till Friedheim
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannes Holthusen
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adina Rapp
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Timo Suntrop
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael F Graessler
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans O Pinnschmidt
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine H Wipper
- Department of Vascular Medicine, University Heart and Vascular Center Hamburg (UHZ), Hamburg, Germany
| | - Mirjam von Lucadou
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Thomas Renné
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; Center for Thrombosis and Hemostasis (CTH), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Karin Pfister
- Department of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Wilma Schierling
- Department of Vascular Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Constantin J C Trepte
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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3
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Hepworth‐Warren KL. Revisiting the use of hydroxyethyl starch solutions in equine fluid therapy. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. L. Hepworth‐Warren
- Department of Clinical Sciences College of Veterinary Medicine North Carolina State University Raleigh North Carolina USA
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4
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Boyd CJ, Brainard BM, Smart L. Intravenous Fluid Administration and the Coagulation System. Front Vet Sci 2021; 8:662504. [PMID: 33937383 PMCID: PMC8081828 DOI: 10.3389/fvets.2021.662504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/15/2021] [Indexed: 12/30/2022] Open
Abstract
Intravenous fluid administration in veterinary patients can alter coagulation function by several mechanisms. Both crystalloid and colloid fluids cause hemodilution, reducing platelet count and plasma coagulation protein concentrations. Hemodilution is associated with a hypercoagulable effect at low dilutions and a hypocoagulable effect at higher dilutions. Composition of crystalloid fluids likely has a minor effect, primarily dependent on fluid ion composition. Hypertonic crystalloids may also cause hypocoagulability. Colloids, both synthetic and natural, can cause hypocoagulability by several mechanisms beyond the effects of hemodilution. These include impaired platelet function, decreased plasma coagulation factor activity, impaired fibrin formation and crosslinking, and accelerated fibrinolysis. The vast majority of the veterinary literature investigates the hypocoagulable effects of hydroxyethyl starch-containing fluids using in vitro, experimental, and clinical studies. However, results are inconsistent, likely due to the varying doses and physicochemical properties of the specific fluid products across studies. In addition, some evidence exists for hypocoagulable effects of gelatin and albumin solutions. There is also evidence that these colloids increase the risk of clinical bleeding in people. Limitations of the veterinary evidence for the hypocoagulable effects of colloid fluids include a predominance of in vitro studies and in vivo studies using healthy subjects, which exclude the interaction of the effects of illness. Therefore, clinical relevance of these effects, especially for low-molecular-weight hydroxyethyl starch, is unknown. Firm recommendations about the most appropriate fluid to use in clinical scenarios cannot be made, although it is prudent to limit the dose of synthetic colloid in at-risk patients. Clinicians should closely monitor relevant coagulation assays and for evidence of hemorrhage in at-risk patients receiving any type of fluid therapy, especially in large volumes.
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Affiliation(s)
- Corrin J Boyd
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Lisa Smart
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
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5
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Crabtree NE, Epstein KL. Current Concepts in Fluid Therapy in Horses. Front Vet Sci 2021; 8:648774. [PMID: 33855057 PMCID: PMC8039297 DOI: 10.3389/fvets.2021.648774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 03/03/2021] [Indexed: 11/13/2022] Open
Abstract
Despite the frequent inclusion of fluid therapy in the treatment of many conditions in horses, there are limited studies available to provide evidenced-based, species-specific recommendations. Thus, equine fluid therapy is based on the application of physiology and extrapolation from evidence in other veterinary species and human medicine. The physiologic principles that underly the use of fluids in medicine are, at first glance, straightforward and simple to understand. However, in the past 20 years, multiple studies in human medicine have shown that creating recommendations based on theory in combination with experimental and/or small clinical studies does not consistently result in best practice. As a result, there are ongoing controversies in human medicine over fluid types, volumes, and routes of administration. For example, the use of 0.9% NaCl as the replacement fluid of choice is being questioned, and the theoretical benefits of colloids have not translated to clinical cases and negative effects are greater than predicted. In this review, the current body of equine research in fluid therapy will be reviewed, connections to the controversies in human medicine and other veterinary species will be explored and, where appropriate, recommendations for fluid therapy in the adult horse will be made based on the available evidence. This review is focused on the decisions surrounding developing a fluid plan involving crystalloids, synthetic colloids, and plasma.
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Affiliation(s)
- Naomi E Crabtree
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, United States
| | - Kira L Epstein
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, Athens, GA, United States
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Munsterman AS, Gillen AM, Coleridge MOD, Hanson RR. Evaluation of the effects of intraabdominal hypertension on equine central venous pressure. J Vet Emerg Crit Care (San Antonio) 2020; 30:653-659. [PMID: 32929882 DOI: 10.1111/vec.13001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 12/17/2018] [Accepted: 02/18/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the effect of changes in intraabdominal pressure (IAP) on central venous pressure (CVP) in normal horses. DESIGN Experimental, in vivo study. SETTING University Teaching Hospital. ANIMALS Convenience sample of 7 mixed breed horses-5 geldings and 2 mares. INTERVENTIONS Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of sustained intraabdominal hypertension. CVP was obtained from the cranial vena cava, concurrent with pressure obtained from the peritoneal cavity. MEASUREMENTS AND MAIN RESULTS CVP increased as IAP increased up to 12 mm Hg, and declined as IAP increased further. The changes in CVP over time were significantly different (P < 0.03). Repeated measures correlation was positive, and highest, for mean CVP as IAP increased from 0 to 12 mm Hg (r = .70; 95% CI, .43-.85; P < 0.0001). Correlation of mean CVP with insufflation pressure became negative as IAP increased further from 15 to 20 mm Hg (r = -.47; 95% CI, -.66 to -.21; P = 0.0006). CONCLUSIONS This report provides preliminary data demonstrating a biphasic trend in equine CVP caused by changes in IAP, similar to that observed in other species. Further investigations are needed to evaluate this trend and to confirm these results in clinical patients.
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Affiliation(s)
- Amelia S Munsterman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Alexandra M Gillen
- The Philip Leverhulme Equine Hospital, University of Liverpool, Chester High Road, Neston, Cheshire, UK
| | | | - R Reid Hanson
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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7
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Kopper JJ, Kogan CJ, Cook VL, Schott HC. Outcome of horses with enterocolitis receiving oncotic fluid support with either plasma or hetastarch. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2019; 60:1207-1212. [PMID: 31692633 PMCID: PMC6805053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The objective of this study was to determine whether there was an association between type of colloid administered and survival of horses with enterocolitis (N = 92). A retrospective review of medical records of horses with enterocolitis treated with plasma or hetastarch (HES) between January 1, 2005 and December 31, 2011 was performed. Data collected included signalment, outcome, physical and clinicopathologic findings, and volume and type of colloid administered. Sixty-nine horses (75%) were treated with plasma and 23 horses (25%) were treated with HES. After accounting for confounding variables, horses treated with plasma (80% survival) were more likely to survive to discharge than horses treated with HES (47% survival; P = 0.041) despite similar disease severity at admission. This study provides support that use of natural colloids may be superior to treatment with synthetic colloids in horses with enterocolitis. A prospective, multi-center trial comparing outcome of critically ill equine patients treated with natural or synthetic colloids is warranted.
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Affiliation(s)
- Jamie J Kopper
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA (Kopper, Cook, Schott II); Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington, USA (Kogan)
| | - Clark J Kogan
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA (Kopper, Cook, Schott II); Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington, USA (Kogan)
| | - Vanessa L Cook
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA (Kopper, Cook, Schott II); Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington, USA (Kogan)
| | - Harold C Schott
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA (Kopper, Cook, Schott II); Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington, USA (Kogan)
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8
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van Galen G, Hallowell G. Hydroxyethyl starches in equine medicine. J Vet Emerg Crit Care (San Antonio) 2019; 29:349-359. [PMID: 31228334 DOI: 10.1111/vec.12854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 06/11/2017] [Accepted: 07/24/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use. DATA SOURCES Veterinary and human peer-reviewed medical literature including scientific reviews, meta-analyses, and original research articles. HUMAN DATA SYNTHESIS Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people. EQUINE VETERINARY DATA SYNTHESIS The rationale for HES use in horses is mainly extrapolated from human medicine, and very limited studies in horses are available. There is limited evidence suggesting a superiority of volume expansion effects of HES over crystalloids. The potential for HES to increase and maintain COP is well supported, but there is no evidence that maintaining or increasing plasma COP influences outcome, tissue edema formation, or rates of complications that potentially relate to edema formation. HES induce dose-dependent changes in coagulopathic parameters, but there is no evidence that HES causes clinical coagulopathies. Insufficient data are available on other adverse effects such as acute kidney injury, or mortality in horses. The use of HES should be restricted in septic patients, but may still have some use in cases of hemorrhagic shock resuscitation, hypoalbuminemia, or perioperative fluid replacement. CONCLUSION The evidence supporting the use of HES in horses is weak due to lack of species-specific investigations. Acknowledging species differences, the use of HES should be judicious, yet with some recognition of its benefits in particular cases. More research is necessary to improve knowledge on use of HES in horses and to establish better future recommendations.
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Affiliation(s)
- Gaby van Galen
- Medicine and Surgery, Department of Large Animal Science, University of Copenhagen, Copenhagen, Denmark
| | - Gayle Hallowell
- School of Veterinary Medicine and Surgery, University of Nottingham, Nottingham, UK
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Abstract
Distal limb wounds in horses heal substantially different than trunk wounds, commonly resulting in exuberant granulation tissue and exposed and sequestered bone. Surgical intervention of severe rectovaginal lacerations in the mare should be delayed until the tissues have heeled and scar tissue has remodeled. Wounds resulting in severe hemorrhage require appropriate emergent fluid therapy and potentially transfusion therapy.
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Affiliation(s)
- Randy B Eggleston
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA 30602, USA.
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10
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Roska S, Morello S, Rajamanickam V, Smith LJ. Effects of hetastarch 130/0.4 on plasma osmolality, colloid osmotic pressure and total protein in horses anaesthetised for elective surgical procedures. Vet Rec 2018; 183:127. [PMID: 29853645 DOI: 10.1136/vr.104634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 04/04/2018] [Accepted: 05/03/2018] [Indexed: 11/04/2022]
Abstract
Effects of lactated Ringer's solution (LRS) and hetastarch 130/0.4 (HES) on colloid osmotic pressure (COP), plasma osmolality (OSM) and total protein (TP) were investigated in 18 inhalational-anaesthetised healthy horses. Horses received 4-6 ml/kg LRS (LRS; n=9) or HES (HES; n=9) from anaesthesia induction through 60 min, after which all were administered LRS. COP, TP and OSM were measured before premedication (baseline), postinduction and 30 (n=18), 60 (n=18), 90 (n=18) and 120 (n=12) minutes. Baseline COP, OSM and TP were not different between groups. TP decreased in both groups at all time points after induction. OSM increased from baseline in HES at 30, 60, 90 and 120 minutes. COP decreased at 30-120 minutes in LRS, and at 90 and 120 minutes in HES. Mean COP was higher in HES than LRS at 30 (18.8±0.5 vs 16.3±0.4 mmHg (P=0.001)), 60 (19.1±0.5 vs 15.9±0.4 mmHg (P<0.0001)) and 90 (17.4±0.5 vs 15.4±0.5 mmHg (P=0.005)) minutes. Sixty minutes of HES infusion increases OSM and transiently maintains COP compared with an equal volume of LRS in anaesthetised horses.
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Affiliation(s)
- Shannon Roska
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Samantha Morello
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Victoria Rajamanickam
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, Institute for Clinical and Translational Research, University of Wisconsin, Madison, Wisconsin, USA
| | - Lesley J Smith
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, USA
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11
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Shaw SD, Stämpfli H. Diagnosis and Treatment of Undifferentiated and Infectious Acute Diarrhea in the Adult Horse. Vet Clin North Am Equine Pract 2018; 34:39-53. [PMID: 29426709 PMCID: PMC7134835 DOI: 10.1016/j.cveq.2017.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Acute, infectious, diarrhea in adult horses is a major cause of morbidity and is associated with numerous complications. Common causes include salmonellosis, clostridiosis, Coronavirus, and infection with Neorickettsia risticii (Potomac horse fever). Treatment is empirical and supportive until results of specific diagnostic tests are available. Supportive care is aimed at restoring hydration, correcting electrolyte imbalances, and limiting the systemic inflammatory response. The mainstays of therapy are intravenous fluid therapy, electrolyte supplementation where necessary, nonsteroidal anti-inflammatory agents, and nutritional support. Specific therapies include colloid oncotic support, antibiotics, hyperimmune plasma, polymyxin B, pentoxifylline, probiotics, binding agents, gastroprotectants, laminitis prevention, and coagulation prophylaxis.
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Affiliation(s)
- Sarah D Shaw
- Rotenberg Veterinary P.C., Palgrave, Ontario LOG 1WO, Canada; Large Animal Medicine, Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - Henry Stämpfli
- Large Animal Medicine, Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
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12
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Hepworth-Warren KL, Hay Kraus BL, Wong DM, Krull AC, Metcalf GL. Septic peritonitis in a Percheron mare associated with Clostridium haemolyticum. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- K. L. Hepworth-Warren
- Lloyd Veterinary Medical Center; College of Veterinary Medicine; Iowa State University; Ames Iowa USA
| | - B. L. Hay Kraus
- Lloyd Veterinary Medical Center; College of Veterinary Medicine; Iowa State University; Ames Iowa USA
| | - D. M. Wong
- Lloyd Veterinary Medical Center; College of Veterinary Medicine; Iowa State University; Ames Iowa USA
| | - A. C. Krull
- Lloyd Veterinary Medical Center; College of Veterinary Medicine; Iowa State University; Ames Iowa USA
| | - G. L. Metcalf
- Lloyd Veterinary Medical Center; College of Veterinary Medicine; Iowa State University; Ames Iowa USA
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13
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Perez-Ecija A, Mendoza FJ. Characterisation of clotting factors, anticoagulant protein activities and viscoelastic analysis in healthy donkeys. Equine Vet J 2017; 49:734-738. [DOI: 10.1111/evj.12685] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. Perez-Ecija
- Department of Animal Medicine and Surgery; University of Cordoba; Cordoba Spain
| | - F. J. Mendoza
- Department of Animal Medicine and Surgery; University of Cordoba; Cordoba Spain
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14
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McKenzie EC, Esser MM, McNitt SE, Payton ME. Effect of infusion of equine plasma or 6% hydroxyethyl starch (600/0.75) solution on plasma colloid osmotic pressure in healthy horses. Am J Vet Res 2017; 77:708-14. [PMID: 27347823 DOI: 10.2460/ajvr.77.7.708] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the effects of equivalent volumes of equine plasma and 6% hydroxyethyl starch (600/0.75) solution (hetastarch) administered IV on plasma colloid osmotic pressure (pCOP) and commonly monitored clinicopathologic variables in horses. ANIMALS 6 healthy mares. PROCEDURES In a randomized, crossover study, horses were administered hetastarch or plasma (both 10 mL/kg, IV) 18 months apart. The pCOP and variables of interest were measured before (baseline), immediately after, and at intervals up to 96 or 120 hours after infusion. Prothrombin and activated partial thromboplastin times were measured before and at 2 and 8 hours after each infusion. RESULTS Prior to hetastarch and plasma infusions, mean ± SEM pCOP was 19.4 ± 0.5 mm Hg and 19.4 ± 0.8 mm Hg, respectively. In general, hetastarch and plasma infusions comparably increased pCOP from baseline for 48 hours, with maximum increases of 2.0 and 2.3 mm Hg, respectively. Mean Hct and hemoglobin, total protein, and albumin concentrations were decreased for a period of 72, 96, or 120 hours after hetastarch infusion with maximum decrements of 8.8%, 3.2 g/dL, 1.2 g/dL, and 0.6 g/dL, respectively. Plasma infusion decreased (albeit not always significantly) hemoglobin concentration and Hct for 20 and 24 hours (maximum changes of 1.5 g/dL and 6.6%, respectively) and increased total solids concentration (maximum change of 0.6 g/dL) for 48 hours. Platelet count and coagulation times were minimally affected. CONCLUSIONS AND CLINICAL RELEVANCE Overall, the hetastarch and plasma infusions comparably increased pCOP in healthy horses for up to 48 hours. Hetastarch induced greater, more persistent perturbations in clinicopathologic variables.
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General Systemic States. Vet Med (Auckl) 2017. [PMCID: PMC7195945 DOI: 10.1016/b978-0-7020-5246-0.00004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Epstein KL, Bergren A, Nie B, Arnold RD, Brainard BM. Comparison of the pharmacokinetics of two formulations of hydroxyethyl starch in healthy horses. J Vet Pharmacol Ther 2016; 40:309-313. [DOI: 10.1111/jvp.12359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 08/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- K. L. Epstein
- Department of Large Animal Medicine; College of Veterinary Medicine; University of Georgia; Athens GA USA
| | - A. Bergren
- Department of Clinical Studies; Cummings School of Veterinary Medicine; Tufts University; Grafton MA USA
| | - B. Nie
- Department of Drug Discovery and Development; Harrison School of Pharmacy; Auburn University; Auburn AL USA
| | - R. D. Arnold
- Department of Drug Discovery and Development; Harrison School of Pharmacy; Auburn University; Auburn AL USA
- Department of Small Animal Medicine and Surgery; College of Veterinary Medicine; University of Georgia; Athens GA USA
| | - B. M. Brainard
- Department of Small Animal Medicine and Surgery; College of Veterinary Medicine; University of Georgia; Athens GA USA
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Gratwick Z, Viljoen A, Page PC, Goddard A, Fosgate GT, Lyle CH. A comparison of the effects of a 4% modified fluid gelatin and a 6% hydroxyethyl starch on haemodilution, colloid osmotic pressure, haemostasis and renal parameters in healthy ponies. Equine Vet J 2016; 49:363-368. [DOI: 10.1111/evj.12594] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 05/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Z. Gratwick
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
| | - A. Viljoen
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
| | - P. C. Page
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
| | - A. Goddard
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
| | - G. T. Fosgate
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
| | - C. H. Lyle
- Department of Companion Animal Clinical Studies; Faculty of Veterinary Science; University of Pretoria; Onderstepoort South Africa
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Brünisholz H, Schwarzwald C, Bettschart-Wolfensberger R, Ringer S. Effects of 10% hydroxyethyl starch (HES 200/0.5) solution in intraoperative fluid therapy management of horses undergoing elective surgical procedures. Vet J 2015; 206:398-403. [DOI: 10.1016/j.tvjl.2015.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/07/2015] [Accepted: 07/20/2015] [Indexed: 12/26/2022]
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Hepworth-Warren KL, Wong DM, Hay-Kraus BL, Wang C, Sun Y. Effects of administration of a synthetic low molecular weight/low molar substitution hydroxyethyl starch solution in healthy neonatal foals. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2015; 56:1069-1074. [PMID: 26483583 PMCID: PMC4572826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study compared the effects of IV administration of isotonic fluid therapy and colloidal fluid therapy in healthy neonatal foals. Fifteen healthy neonatal foals were used in a randomized blinded prospective clinical study. Foals were randomly assigned to receive a bolus of 20 mL/kg of tetrastarch (TES) or balanced crystalloid solution. Vital parameters, colloid osmotic pressure (COP), and various clinicopathologic variables were assessed prior to infusion and at various time points up to 120 h after infusion. The treatment group (TES) had a significant increase in both COP and percentage increase in COP at 1 and 3 h. The COP was significantly lower than baseline at 3 h in the control group. No significant changes were observed in coagulation parameters in either group. Tetrastarch was effective in increasing COP for 3 h after infusion and had no notable adverse clinical effects in this group of healthy foals. Further studies are warranted regarding optimal dosing and effects in clinically ill foals.
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Davis JL. Nonsteroidal anti-inflammatory drug associated right dorsal colitis in the horse. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- J. L. Davis
- North Carolina State University College of Veterinary Medicine; Raleigh USA
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Cazzolli D, Prittie J. The crystalloid-colloid debate: Consequences of resuscitation fluid selection in veterinary critical care. J Vet Emerg Crit Care (San Antonio) 2015; 25:6-19. [DOI: 10.1111/vec.12281] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 10/30/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Dava Cazzolli
- Animal Medical Center; Department of Emergency and Critical Care; New York NY
| | - Jennifer Prittie
- Animal Medical Center; Department of Emergency and Critical Care; New York NY
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The effect of colloid formulation on colloid osmotic pressure in horses with naturally occurring gastrointestinal disease. BMC Vet Res 2014; 10 Suppl 1:S8. [PMID: 25237987 PMCID: PMC4123155 DOI: 10.1186/1746-6148-10-s1-s8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Naturally occurring gastrointestinal disease is an important cause of acute hypoproteinemia in adult horses and hydroxyethyl starch colloid fluid treatment is a component of supportive care in these cases to improve plasma volume and maintain colloid osmotic pressure (COP). The objectives of the present study were to compare 2 formulations of high molecular weight hydroxyethyl starch and their relative effect on COP, acid-base status, and survival of horses with acute hypoproteinemia secondary to gastrointestinal disease. Methods Twenty adult horses, ≥ 1 year of age, were prospectively enrolled, with informed client consent, if they developed acute hypoproteinemia, defined as a plasma total protein <5.0 g/dL or albumin <2.2 g/dL during hospitalization while undergoing treatment for gastrointestinal disease. Horses were randomly assigned to receive a rapid infusion of either 6% hydroxyethyl starch in 0.9% saline or 6% hydroxyethyl starch in lactated ringers solution at a dose of 10ml/kg. Venous blood gas analysis, COP, and PCV were evaluated before and after colloid administration. Results For both groups, average COP prior to treatment was 11.0 mmHg (9.7 – 12.2 mmHg) and post colloid treatment was 13.2 mmHg (12.0 -14.7 mmHg) [Normal range 18 – 22 mmHg]. COP was significantly increased with colloid treatment (p<0.001) but this increase was not significantly different between treatment groups. Venous pH did not change significantly with treatment. Twelve horses survived to hospital discharge and survival did not differ significantly between treatment groups. Conclusions Post-treatment COP improved approximately 20% regardless of the formulation used, however, values did not reach the normal range of COP observed in healthy horses. Acid-base parameters were not significantly impacted by either treatment. Further study is needed to determine how these two products compare with regards to other outcome measures. Evaluation of the relative effects of colloid formulation in horses with clinical disease is a future area of interest.
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