need help on cytopempsis

[ketap]

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hi, do anyone of u read "anesthesiology" by Longnecker?
i am quiet interested by the term cytopempsis mentioned in that book...it is interesting because the book is telling us that the cytopempsis is the reason for giving more crystalloid for blood loss ratio..but i don't understand this term quiet well,

i don't understand why increasing extracellular space more compliant would increase the transcapilllary leakage ? shouldn't increasing the extracellular space volume would instead increase the interstitial hydrostatic pressure?

and if the conventional crystalloid: blood ratio is not 3:1 again and i t can varies a lot , how can i know what ratio would be enough for my patient?

i have searched in other sources but i can't find anything about this ...could please someone explain it to me? thx u so much

here i quote how the book explained about this term

Quote
Traditional approaches to blood replacement have identified a 3:1 ratio of crystalloid to blood loss. This is incorrect. With increasing volumes of crystalloid administration the extracellular space becomes progressively more compliant, resulting in a geometric increase in transcapillary leakage
that volume replacement for blood loss parallels. This process is known
as cytopempsis and principally reflects the progressive hypoalbuminemia associated with volume replacement.

 

[gasaddict54]

hi, do anyone of u read "anesthesiology" by Longnecker?
i am quiet interested by the term cytopempsis mentioned in that book...it is interesting because the book is telling us that the cytopempsis is the reason for giving more crystalloid for blood loss ratio..but i don't understand this term quiet well,

i don't understand why increasing extracellular space more compliant would increase the transcapilllary leakage ? shouldn't increasing the extracellular space volume would instead increase the interstitial hydrostatic pressure?

and if the conventional crystalloid: blood ratio is not 3:1 again and i t can varies a lot , how can i know what ratio would be enough for my patient?

i have searched in other sources but i can't find anything about this ...could please someone explain it to me? thx u so much

here i quote how the book explained about this term

Quote
Traditional approaches to blood replacement have identified a 3:1 ratio of crystalloid to blood loss. This is incorrect. With increasing volumes of crystalloid administration the extracellular space becomes progressively more compliant, resulting in a geometric increase in transcapillary leakage
that volume replacement for blood loss parallels. This process is known
as cytopempsis and principally reflects the progressive hypoalbuminemia associated with volume replacement.

this may be way off but my understanding is that crystalloid vs colloid over a period of time remains intravascular at relatively 50% vs colloid in both time and overall volume. This is reflected by cytopempsis w crystalloid. My take is simply if u need alot of volume replacement u need to use something other than just crystalloid all the time or you are going to have problems w dilutional hypoalbuminemia and those effects associated etc

 

[urge]

Quote
Traditional approaches to blood replacement have identified a 3:1 ratio of crystalloid to blood loss. This is incorrect. With increasing volumes of crystalloid administration the extracellular space becomes progressively more compliant, resulting in a geometric increase in transcapillary leakage
that volume replacement for blood loss parallels. This process is known
as cytopempsis and principally reflects the progressive hypoalbuminemia associated with volume replacement.

What do they say is correct?

 

[Curious Biff]

You should look at the SAFE trial. Suffice to say this is a long-argued debate to which no one really knows the right answer.

Biff

 

[dhb]

you are going to have problems w dilutional hypoalbuminemia

Strong work, maybe delusional resident is the term for you 😱

 

[gasaddict54]

Strong work, maybe delusional resident is the term for you 😱

maybe u care to elaborate? or just be a douche?

 

[dhb]

maybe u care to elaborate? or just be a douche?

If you want to acheive the same plasma expantion you will get the same dilution regardless of the nature of the fluid.