title: The impact of crystalloidal and colloidal infusion preparations on coronary vascular integrity, interstitial oedema and cardiac performance in isolated hearts.
abstract: BACKGROUND
  Recent data suggested an interaction between plasma constituents and the endothelial glycocalyx to be relevant for vascular barrier function. This might be negatively influenced by infusion solutions, depending on ionic composition, pH and binding properties. The present study evaluated such an influence of current artificial preparations.
  
  
  METHODS
  Isolated guinea pig hearts were prepared in a modified Langendorff mode and perfused with Krebs-Henseleit buffer augmented with 1g% human albumin. After equilibration the perfusion was switched to replacement of one half buffer by either isotonic saline (NaCl), ringer's acetate (Ri-Ac), 6% and 10% hydroxyethyl starch (6% and 10% HES, resp.), or 4% gelatine (Gel), the artificial colloids having been prepared in balanced solution. We analysed glycocalyx shedding, functional integrity of the vascular barrier and heart performance.
  
  
  RESULTS
  While glycocalyx shedding was not observed, diluting albumin concentration towards 0.5g% by artificial solutions was associated with a marked functional breakdown of vascular barrier competence. This effect was biggest with isotonic saline and significantly attenuated with artificial colloids, the difference in the pressure dependent transvascular fluid filtration (basal vs. during infusion in groups NaCl, Ri-Ac, 6% HES, 10% HES and Gel, n = 6 each) being 0.31 ± 0.03 vs. 1.00 ± 0.04; 0.27 ± 0.03 vs. 0.81 ± 0.03; 0.29 ± 0.03 vs. 0.68 ± 0.02; 0.32 ± 0.03 vs. 0.59 ± 0.08 and 0.31 ± 0.04 vs. 0.61 ± 0.03 g/5min, respectively. Heart performance was directly related to pH value (7.38 ± 0.06, 7.33 ± 0.03, 7.14 ± 0.04, 7.08 ± 0.04, 7.25 ± 0.03), the change in the rate pressure product being 21,702 ± 1969 vs. 21,291 ± 2,552; 22,098 ± 2,115 vs. 14,114 ± 3,386; 20,897 ± 2,083 vs. 10,671 ± 1,948; 21,822 ± 2,470 vs. 10,047 ± 2,320 and 20,955 ± 2,296 vs. 15,951 ± 2,755 mmHg × bpm, respectively.
  
  
  CONCLUSIONS
  It appears important to maintain the pH value within a physiological range to maintain optimal myocardial contractility. Using colloids prepared in calcium-containing, balanced solutions for volume replacement therapy may attenuate the breakdown of vascular barrier competence in the critically ill.
authors.forename: York A
authors.initials: YA
authors.lastname: Zausig
authors.forename: Daniel
authors.initials: D
authors.lastname: Chappell
authors.forename: Bernhard F
authors.initials: BF
authors.lastname: Becker
authors.forename: Daniel
authors.initials: D
authors.lastname: Potschka
authors.forename: Hendrik
authors.initials: H
authors.lastname: Busse
authors.forename: Kathrin
authors.initials: K
authors.lastname: Nixdorf
authors.forename: Diane
authors.initials: D
authors.lastname: Bitzinger
authors.forename: Barbara
authors.initials: B
authors.lastname: Jacob
authors.forename: Matthias
authors.initials: M
authors.lastname: Jacob
mesh_terms: D000818:Animals; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects*; D003331:Coronary Vessels / Q000187:drug effects* / Q000502:physiology; D000077324:Crystalloid Solutions; D004487:Edema / Q000188:drug therapy* / Q000503:physiopathology; D006168:Guinea Pigs; D006321:Heart / Q000187:drug effects* / Q000502:physiology; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D009924:Organ Culture Techniques; D011897:Random Allocation
chemical_list: D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions
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