Plasma substitutes Gelatin

Other important examples are blood and blood products, which are collected and processed in sterile containers, and plasma substitutes, for example dextrans and degraded gelatin. Dextrans, glucose polymers consisting essentially of (1 - 6) a-links, are produced as a result of the biochemical activities of certain bacteria of the genus Leuconostoc, e.g. L. mesenteroides (see Chapter 25). 

Gelatin is a plasma substitute. Plasma substitutes should not be used to maintain plasma volume in burns or peritonitis. In these scenarios albumin should be given. Close monitoring, including monitoring of fluid and electrolyte balance and urine output, is required in patients being administered plasma and plasma substitutes. Plasma substitutes should also be used with caution in patients with cardiac disease, liver disease or renal impairment. 

The pathomechanism of HES-induced anaphylactoid reactions is unknown. Since HES has been in general clinical use for a comparatively short time, only a few data are available for critical evaluation of the triggering mechanisms of adverse reactions. From the physicochemical properties of HES a few possible mechanisms may, however, be visualized. Comparing the occurrence in humans of preformed antibodies reactive with plasma substitutes, it is evident that both titers and frequency are highest for gelatin, intermediate for dextran, and lowest for HES. In this connection, it is interesting to note that upon rapid infusion of HES into hu-... 

Lundgsgaard-Hansen P, Hassig A, Mitschmann H (eds) (1969) Modified gelatin as plasma substitutes. Karger, Basel... 

Zekom, D. Intravascular retention, dispersal, excretion and break-down of gelatin plasma substitutes, in Modified Gelatins as Plasma Substitutes Bibl Haematol 33, p. 131, Basel-New York, Karger 1969... 

Acetic anhydride is an important industrial reagent. Over one-half its annual production of approximafely 750,000 fons is used for the manufacture of cellulose acetate. Cellulose acetate is a wddely used textile fiber and is the chief component of cigarette filters. Acetic anhydride is the acetylation reagent used for the production of aspirin (acetylsalicylic acid). Succinic anhydride finds use in the succinylation of gelatin used as a blood plasma substitute, as a food preservative in chicken against Salmonella, and as a dog food preservative. 

Hydrolyzed protein can also be prepared so that the particles are of sufSciently large size to exert colloidal osmotic pressure. Such preparations may act as plasma substitutes. This is really what happens when gelatin solutions are used, as already mentioned. A papain digest of casein has been described by Brinkman (6), which seems to have col-... 

Hypersensitivity reactions of the skin and respiratory system have been reported in a study made at random of 750 orthopaedic surgery cases, who received 5 different plasma substitutes preceding anaesthesia. Side effects, especiahy erythema and urticaria, itching and oedemata, rhinorrhoea and asthmatic conditions, were observed in 21.3% with gelatin derivatives, 3% with Macrodex... 

Contrary to earlier clinical observations, the i.v. use of a modified gelatin (Neo-Plasmagel) as a plasma substitute did not provoke side effects in 265 patients during spinal anaesthesia. The infusion of 500 ml was performed in 30 minutes. One case out of the 265 patients showed slight shivering, which disappeared after giving 1000 mg calcium i.v. (20). 

A substance used in medicine as a substitute for blood plasma, e.g., dextran, gelatin, or polyvinylpy-rollidone. 

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