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Water content of the endothelial glycocalyx layer estimated by volume kinetic analysis
Intensive Care Medicine Experimental Pub Date : 2020-07-10 , DOI: 10.1186/s40635-020-00317-z
Robert G Hahn 1, 2
Affiliation  

Background The water volume of the endothelial glycocalyx layer has been estimated at 0.7 to 1.7 L using tracer methods of unclear value. The present study attempts to measure this fluid volume by analyzing the kinetics of a crystalloid fluid load. Methods An intravenous infusion of approximately 1 L of Ringer’s acetate was administered to 35 healthy volunteers, and the central volume of distribution of the water volume was calculated from the urinary excretion and frequent measurements of the fluid-induced hemodilution using mixed-effects modeling software. Comparisons were made with the plasma volume derived from three published anthropometric regression equations based on isotope measurements. In a second analysis, up to 2.5 L of Ringer’s was administered to 60 volunteers selected from a cohort of 160 to have as similar hematocrits as possible to the volunteers whose data were used to create the anthropometric equations. Results Volume kinetics showed that the infused crystalloid fluid occupied a larger central fluid space than was estimated with the isotope measurements. The first analysis of the 35 subjects indicated a mean difference of 0.51 L in males and 0.49 L in females. The second, larger analysis showed a mean excess volume of 0.43 L, which was approximately 15% of the circulating plasma volume. Conclusions A crystalloid fluid load expands a 0.4–0.5 L larger central fluid space than the circulating plasma volume. The excess volume is probably located in the glycocalyx layer.

中文翻译:

通过体积动力学分析估计的内皮糖萼层的含水量

背景 使用价值不明的示踪方法估计内皮糖萼层的水体积为 0.7 至 1.7 L。本研究试图通过分析晶体流体负载的动力学来测量该流体体积。方法 对 35 名健康志愿者静脉输注约 1 L 林格氏醋酸盐,并使用混合效应建模软件根据尿排泄量和液体引起的血液稀释的频繁测量来计算水体积的中心分布容积。与基于同位素测量的三个已发表的人体测量回归方程得出的血浆体积进行了比较。在第二次分析中,最多为 2。从 160 人的队列中选出 60 名志愿者服用 5 L Ringer's,以使其血细胞比容与其数据用于创建人体测量方程的志愿者尽可能相似。结果 体积动力学表明,注入的晶体流体占据了比同位素测量估计的更大的中心流体空间。对 35 名受试者的第一次分析表明,男性和女性的平均差异分别为 0.51 L 和 0.49 L。第二个较大的分析显示平均过量体积为 0.43 L,约为循环血浆体积的 15%。结论 晶体液负荷比循环血浆体积扩大了 0.4-0.5 L 的中心流体空间。多余的体积可能位于糖萼层中。结果 体积动力学表明,注入的晶体流体占据了比同位素测量估计的更大的中心流体空间。对 35 名受试者的第一次分析表明,男性和女性的平均差异分别为 0.51 L 和 0.49 L。第二个较大的分析显示平均过量体积为 0.43 L,约为循环血浆体积的 15%。结论 晶体液负荷比循环血浆体积扩大了 0.4-0.5 L 的中心流体空间。多余的体积可能位于糖萼层中。结果 体积动力学表明,注入的晶体流体占据了比同位素测量估计的更大的中心流体空间。对 35 名受试者的第一次分析表明,男性和女性的平均差异分别为 0.51 L 和 0.49 L。第二个较大的分析显示平均过量体积为 0.43 L,约为循环血浆体积的 15%。结论 晶体液负荷比循环血浆体积扩大了 0.4-0.5 L 的中心流体空间。多余的体积可能位于糖萼层中。较大的分析显示平均过量体积为 0.43 L,约为循环血浆体积的 15%。结论 晶体液负荷比循环血浆体积扩大了 0.4-0.5 L 的中心流体空间。多余的体积可能位于糖萼层中。较大的分析显示平均过量体积为 0.43 L,约为循环血浆体积的 15%。结论 晶体液负荷比循环血浆体积扩大了 0.4-0.5 L 的中心流体空间。多余的体积可能位于糖萼层中。
更新日期:2020-07-10
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