Alteration of anion gap during almost total plasma replacement with synthetic colloids in piglets

In ten piglets (body weight 8.2-11.6 kg), acid base, electrolyte and anion gap changes were investigated during almost total plasma replacement with hydroxyethyl starch (HES) and modified fluid gelatin (GEL) in saline solution using a cell saver autotransfusion technique. During the study, there wer...

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Bibliographic Details
Published in:Intensive care medicine 1999-11, Vol.25 (11), p.1287-1290
Main Authors: SÜMPELMANN, R, SCHÜRHOLZ, T, MARX, G, THORNS, E, ZANDER, R
Format: Article
Language:English
Subjects:
Acid-Base Equilibrium - drug effects
Acidosis
Acids
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Animals, Newborn
Biological and medical sciences
Blood
Blood Transfusion, Autologous
Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis
Catheters
Chloride
Colloids - pharmacology
Disease Models, Animal
Electrolytes
Electrolytes - blood
Female
Fluid Therapy
Gelatin - pharmacology
Hemodynamics
Hemoglobin
Hogs
Hydrogen-Ion Concentration - drug effects
Hydroxyethyl Starch Derivatives - pharmacology
Medical sciences
Metabolism
Molecular weight
Plasma
Plasma Substitutes - pharmacology
Potassium
Pulmonary arteries
Random Allocation
Sodium
Succinates - pharmacology
Swine
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Veins & arteries
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Summary:In ten piglets (body weight 8.2-11.6 kg), acid base, electrolyte and anion gap changes were investigated during almost total plasma replacement with hydroxyethyl starch (HES) and modified fluid gelatin (GEL) in saline solution using a cell saver autotransfusion technique. During the study, there were only moderate acid base changes, but marked disturbances in anion balance. At study end, the mean chloride concentration was significantly higher (mmol/l: normal values 97-108, HES 116 +/- 1.5, GEL 108 +/- 1.1, p < 0.01) and the mean anion gap was significantly lower in the HES group in comparison to the GEL group (mmol/l: normal values 5-14, HES 3 +/- 1.7, GEL 11.9 +/- 0.9, p < 0.01). It is concluded that plasma replacement with electroneutral HES, but not with negatively charged GEL, can lower the anion gap irrespective of the underlying disease. This can be misleading when the anion gap is used for differential diagnosis of metabolic acidosis in patients after large volume infusion of synthetic colloids.
ISSN:0342-4642
1432-1238
DOI:10.1007/s001340051059