Central and noncentral blood volumes in cirrhosis: relationship to anthropometrics and gender

2003 ◽  
Vol 284 (6) ◽  
pp. G970-G979 ◽  
Author(s):  
Søren Møller ◽  
Jens H. Henriksen ◽  
Flemming Bendtsen
Keyword(s):  
Lean Body Mass ◽  
Blood Volume ◽  
Body Mass ◽  
Healthy Controls ◽  
Total Blood ◽  
Body Dimensions ◽  
Arterial Blood ◽  
And Gender ◽  
Blood Volumes

The size of the central and arterial blood volume (CBV) is essential in the understanding of fluid retention in cirrhosis. Previously, it has been reported decreased, normal, or increased, but no reports have analyzed CBV with respect to gender and lean body mass. The aim of the present study was by means of an optimized technique to reassess it in a large group of patients with cirrhosis compared with healthy controls and matched controls in relationship to their body dimensions and gender. Eighty-three patients with cirrhosis (male/female, 60:23), 67 patients without liver disease (male/female, 22:45), and 14 young healthy controls (male/female, 6:8) underwent a hemodynamic investigation with determination of cardiac output, central circulation time, and CBV determined according to kinetic principles. Related to gender, CBV was lower in male cirrhotics (1.48 ± 0.30 liter) than in matched and young controls (1.68 ± 0.33 and 1.72 ± 0.33 liter, respectively; P < 0.05–0.01). No significant differences in CBV were seen between female cirrhotics and controls. Absolute and adjusted CBVs were lower in the females than in men with cirrhosis ( P < 0.001), and men with cirrhosis had lower absolute and body weight-adjusted CBVs than matched controls ( P< 0.01). Normalized values of CBV (%total blood volume) were significantly lower in patients with cirrhosis (25 ± 4%) than in matched controls (31 ± 7%) and young controls (28 ± 4%; P < 0.02). CBV correlated significantly with anthropometrics, including lean body mass ( r = 0.68–0.82; P < 0.0001). In conclusion, the CBV of patients with cirrhosis was lower than that of controls when adjusted for body dimensions and gender. There are significant gender differences, and signs of underfilling are more pronounced in male than in female patients. The results emphasize the importance of adjustments of blood volumes for anthropometrics and gender.

Influence of Age and Gender on the Pharmacokinetics and Pharmacodynamics of Remifentanil

1997 ◽  
Vol 86 (1) ◽  
pp. 10-23 ◽  
Author(s):  
Charles F. Minto ◽  
Thomas W. Schnider ◽  
Talmage D. Egan ◽  
Elizabeth Youngs ◽  
Harry J. M. Lemmens ◽  
...  
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Pharmacodynamic Model ◽  
Pharmacodynamic Modeling ◽  
Pharmacokinetic Parameters ◽  
Population Pharmacokinetic ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Age And Gender ◽  
Arterial Blood ◽  
And Gender

Background Previous studies have reported conflicting results concerning the influence of age and gender on the pharmacokinetics and pharmacodynamics of fentanyl, alfentanil, and sufentanil. The aim of this study was to determine the influence of age and gender on the pharmacokinetics and pharmacodynamics of the new short-acting opioid remifentanil. Methods Sixty-five healthy adults (38 men and 27 women) ages 20 to 85 y received remifentanil by constant-rate infusion of 1 to 8 micrograms.kg-1.min-1 for 4 to 20 min. Frequent arterial blood samples were drawn and assayed for remifentanil concentration. The electroencephalogram was used as a measure of drug effect. Population pharmacokinetic and pharmacodynamic modeling was performed using the software package NONMEM. The influence of volunteer covariates were analyzed using a generalized additive model. The performances of the simple (without covariates) and complex (with covariates) models were evaluated prospectively in an additional 15 healthy participants ages 41 to 84 y. Results The parameters for the simple three-compartment pharmacokinetic model were V1 = 4.98 l, V2 = 9.01 l, V3 = 6.54 l, Cl1 = 2.46 l/min, Cl2 = 1.69 l/min, and Cl3 = 0.065 l/min. Age and lean body mass were significant covariates. From the ages of 20 to 85 y, V1 and Cl1 decreased by approximately 25% and 33%, respectively. The parameters for the simple sigmoid Emax pharmacodynamic model were Ke0 = 0.516 min-1, E0 = 20 Hz, Emax = 5.62 Hz, EC50 = 11.2 ng/ml, and gamma = 2.51. Age was a significant covariate of EC50 and Ke0, with both decreasing by approximately 50% for the age range studied. The complex pharmacokinetic-pharmacodynamic model performed better than did the simple model when applied prospectively. Conclusions This study identified (1) an effect of age on the pharmacokinetics and pharmacodynamics of remifentanil; (2) an effect of lean body mass on the pharmacokinetic parameters; and (3) no influence of gender on any pharmacokinetic or pharmacodynamic parameter.

Normal Values of Hemoglobin Mass and Blood Volume in Young, Active Women and Men

2019 ◽  
Vol 40 (04) ◽  
pp. 236-244 ◽  
Author(s):  
Roberto Falz ◽  
Sven Fikenzer ◽  
Stephan Hoppe ◽  
Martin Busse
Keyword(s):  
Lean Body Mass ◽  
Blood Volume ◽  
Body Mass ◽  
Normal Values ◽  
Fluid Management ◽  
Impedance Analysis ◽  
Total Blood ◽  
Entire Study ◽  
Young Subjects ◽  
Hemoglobin Mass

AbstractHemoglobin mass (Hbmass) and total blood volume (BV) determine the oxygen content in the blood. Varying anthropometric values are used to standardize blood volume and Hbmass. The aim of this study was to create normal values and to evaluate an anthropometric reference for Hbmass and BV. One hundred healthy young subjects participated in this study (50 women: 20.9±2.0 yr; 50 men: 23.2±2.9 yr). The Hbmass was measured twice by using a CO rebreathing method. The BV was calculated from the Hbmass, Hb concentration and hematocrit values. The lean body mass (LBM) was measured by a bio-impedance analysis. Women had a significant lower Hbmass per kg LBM compared with that of men (13.6±1.3 g vs. 16.1±1.7 g; p<0.0001). The BV per kg LBM tended to be lower in women than in men (105.3±8.4 ml vs. 108.7±9.0 ml; p=0.0548). LBM had the best correlation with Hbmass (r=0.9274) and BV (0.9233) when considering the entire study group. Normal values of Hbmass and BV could be potentially useful for fluid management and contribute to the diagnosis of blood disorders. For normalization and assessment of measured BV and Hbmass, lean body mass should be prioritized in future studies instead of body weight or body surface area.

Measurement of Blood Volumes in the Splanchnic Bed of the Dog

1957 ◽  
Vol 189 (3) ◽  
pp. 573-575 ◽  
Author(s):  
Steven M. Horvath ◽  
T. Kelly ◽  
G. E. Folk ◽  
B. K. Hutt
Keyword(s):  
Blood Volume ◽  
Precise Measurement ◽  
Total Blood Volume ◽  
Total Blood ◽  
Blood Volumes

Measurements of the distribution of blood volumes between the splanchnic and peripheral beds of dogs have been made. The splanchnic blood volume was found to be 21% of the total blood volume. The fractionation of the splanchnic blood volume between hepatic, splenic and mesenteric beds indicated that these contained approximately 30, 30 and 40%, respectively. There were certain difficulties which precluded precise measurement of the splanchnic fractions.

Estimation of blood pressure-related parameters by electrical impedance measurement

1992 ◽  
Vol 73 (5) ◽  
pp. 1946-1957 ◽  
Author(s):  
J. H. Muntinga ◽  
K. R. Visser
Keyword(s):  
Blood Pressure ◽  
Blood Volume ◽  
Electrical Impedance ◽  
Cuff Pressure ◽  
Arterial Compliance ◽  
Blood Pressure Measurement ◽  
Venous Blood ◽  
Impedance Measurement ◽  
Total Blood ◽  
Arterial Blood

In 13 healthy volunteers a computerized experimental set-up was used to measure the electrical impedance of the upper arm at changing cuff pressure, together with the finger arterial blood pressure in the contralateral arm. On the basis of a model for the admittance response, the arterial blood volume per centimeter length (1.4 +/- 0.3 ml/cm), the venous blood volume as a percentage of the total blood compartment (49.2 +/- 12.6%), and the total arterial compliance as a function of mean arterial transmural pressure were estimated. The effective physiological arterial compliance amounted to 2.0 +/- 1.3 microliters.mmHg-1.cm-1 and the maximum compliance to 33.4 +/- 12.0 microliters.mmHg-1.cm-1. Additionally, the extravascular fluid volume expelled by the occluding cuff (0.3 +/- 0.3 ml/cm) was estimated. These quantities are closely related to patient-dependent sources of an unreliable blood pressure measurement and vary with changes in cardiovascular function, such as those found in hypertension. Traditionally, a combination of several methods is needed to estimate them. Such methods, however, usually neglect the contribution of extravascular factors.

Circulating blood volumes in pulmonary hypertension associated with erythrocytosis – the effects of therapeutic hemodilution

2003 ◽  
Vol 13 (6) ◽  
pp. 544-550 ◽  
Author(s):  
Rilvani C. Gonçalves ◽  
Carlos Alberto Buschpigell ◽  
Antonio Augusto Lopes
Keyword(s):  
Pulmonary Hypertension ◽  
Blood Volume ◽  
Plasma Volume ◽  
Cell Mass ◽  
Red Cell ◽  
Total Blood Volume ◽  
Eisenmenger Syndrome ◽  
Total Blood ◽  
Red Cell Mass ◽  
Blood Volumes

In the Eisenmenger syndrome, indirect estimation of blood volumes may provide quite inaccurate information when seeking to define therapeutic strategies. With this in mind, we analyzed directly the red cell mass, plasma volume, and total blood volume in patients with pulmonary hypertension associated with congenital cardiac defects and erythrocytosis, comparing the results with the respective estimated volumes, and examining the changes induced by therapeutic hemodilution.Thus, we studied 17 patients with the Eisenmenger syndrome, aged from 15 to 53 years, in the basal condition, studying 12 of them both before and after hemodilution. We also investigated five individuals with minimal cardiac lesions, aged from 14 to 42 years, as controls. Red cell mass and plasma volumes were measured using [51 chromium]-sodium chromate and [131iodine]-albumin respectively. Hemodilution was planned so as to exchange 10% of the total blood volume, using 40,000 molecular weight dextran simultaneously to replace the removed volume. The mean values of the red cell mass, plasma volume and total blood volume as assessed by radionuclide techniques were 32%, 31% and 32% higher than the respective volumes as estimated using empirical mathematical formulas (p < 0.002). The measured total blood volume was also 19% higher in the patients compared with controls. Following a period of 5 days after hemodilution, we noted a 13% reduction in red cell mass (p = 0.046), and 10% reduction in total blood volume (p = 0.02), albeit with no changes in the plasma volume.We conclude that direct measurement of blood volumes is useful for proper management of these patients, and provides results that are considerably different from those obtained by empirical estimations.

Determination of residual blood volume required for survival in rapidly hemorrhaged splenectomized dogs

1958 ◽  
Vol 196 (1) ◽  
pp. 179-183 ◽  
Author(s):  
R. A. Rawson ◽  
Shu Chien ◽  
M. T. Peng ◽  
R. J. Dellenback
Keyword(s):  
Blood Volume ◽  
Severe Hemorrhage ◽  
Volume Measurements ◽  
Residual Blood ◽  
Blood Volumes

Twenty-four splenectomized dogs (average blood volume of 83 ml/kg) were hemorrhaged from 43–55% of their control blood volumes. The Fcells factor as determined from cell (Cr51) and plasma (T-1824) volume measurements was unchanged by severe hemorrhage. (0.88, S.D., 0.020 before and 0.88, S.D., 0.028 after hemorrhage). There were 12 survivors and 12 nonsurvivors. Fifty per cent survival occurred at a residual blood volume of 61%. The results are compared with previous studies in this laboratory and discussed in relation to factors that appear to influence the tolerance to reduction in blood volume.

Determination of rate of cross circulation in parabiotic rats with P32-labeled erythrocytes

1959 ◽  
Vol 196 (4) ◽  
pp. 753-756 ◽  
Author(s):  
David G. Fleming ◽  
Laura Caldwell ◽  
Roberta Jacobs
Keyword(s):  
Body Weight ◽  
Blood Volume ◽  
Sodium Phosphate ◽  
Femoral Vein ◽  
Total Activity ◽  
Female Rats ◽  
Blood Samples ◽  
Litter Mate ◽  
Blood Volumes

Litter-mate female rats parabiosed at 21 days by the Bunster-Meyer method were allowed to mature for several months. Volumes of blood obtained from donor animals were incubated at 37°C with P32, in the form of buffered isotonic sodium phosphate. A plasma-free suspension of labeled erythrocytes was prepared and a sample of known activity was injected into the femoral vein of one member of each parabiotic pair. Four pairs of 100 lambda blood samples, obtained by venipuncture, were taken at varying intervals, for the succeeding 150 minutes. Using the dye dilution principle, it was possible to determine the blood volume of the injected rat after the first sample, and that of the pair at the time of equilibrium. The average blood volume was 6.53% of body weight. The concentration of tagged cells reached equal values in both members of the pairs at an average time of 90 minutes. There was less than a 20% loss of total activity in all the pairs used for determinations. An equation was derived for the calculation of the rate of exchange. The average for 15 pairs was 2.09 blood volumes per hour. The range was from 3.95 bl. vol/hr. in the fastest pair to 0.74 bl. vol/hr. in the slowest.

Detection of early central circulatory transits in patients with cirrhosis by gamma variate fit of indicator dilution profiles

2005 ◽  
Vol 288 (4) ◽  
pp. G677-G684 ◽  
Author(s):  
Jens H. Henriksen ◽  
Søren Møller ◽  
Stefan Fuglsang ◽  
Flemming Bendtsen
Keyword(s):  
Cardiac Output ◽  
Blood Volume ◽  
Indicator Dilution ◽  
Arterial Oxygen ◽  
Dilution Method ◽  
Gamma Variate ◽  
Arterial Blood ◽  
Flow Circulation ◽  
Cirrhotic Patients

Patients with cirrhosis have hyperdynamic circulation with abnormally distributed blood volume and widespread arteriovenous communications. We aimed to detect possible very early (i.e., before 4 s) and early (i.e., after 4 s) central circulatory transits and their potential influence on determination of central and arterial blood volume (CBV). Thirty-six cirrhotic patients and nineteen controls without liver disease undergoing hemodynamic catheterization were given central bolus injections of albumin with different labels. Exponential and gamma variate fits were applied to the indicator dilution curves, and the relations between flow, circulation times, and volumes were established according to kinetic principles. No significant very early central circulatory transits were identified. In contrast, early (i.e., 4 s to maximal) transits corresponding to a mean of 5.1% (vs. 0.8% in controls; P < 0.005) of cardiac output (equivalent to 0.36 vs. 0.05 l/min; P < 0.01) were found in cirrhotic patients. These early transits averaged 7.7 vs. 12.7 and 17.2 s of ordinary central transits of cirrhotic patients and controls, respectively ( P < 0.001). Early transits were directly correlated to the alveolar-arterial oxygen difference in the cirrhotic patients ( r = 0.46, P < 0.01) but not in controls ( r = 0.04; not significant). There was good agreement between the CBV determined by the conventional indicator dilution method and that determined by separation of early and ordinary transits by the gamma variate fit method (1.51 vs. 1.53 liter; not significant). In conclusion, no very early central circulatory transits were identified in cirrhotic patients. A significant part of the cardiac output undergoes an early transit, probably through pulmonary shunts or areas with low ventilation-perfusion ratios in cirrhotic patients. Composite determination of CBV by the gamma variate fit method is in close agreement with established kinetic methods. The study provides further evidence of abnormal central circulation in cirrhosis.

Assessment and Determination of Lean Body Mass Deficiency in Ukrainian Women

2016 ◽  
Vol 19 (4) ◽  
pp. 524
Author(s):  
Vladyslav Povoroznyuk ◽  
Nataliia Dzerovych ◽  
Roksolana Povoroznyuk
Keyword(s):  
Lean Body Mass ◽  
Body Mass

scholarly journals Reduced Appendicular Lean Body Mass, Muscle Strength, and Size of Type II Muscle Fibers in Patients with Spondyloarthritis versus Healthy Controls: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Kristine Røren Nordén ◽  
Hanne Dagfinrud ◽  
Amund Løvstad ◽  
Truls Raastad
Keyword(s):  
Body Composition ◽  
Muscle Strength ◽  
Lean Body Mass ◽  
Body Mass ◽  
Muscle Fibers ◽  
Type I ◽  
Healthy Controls ◽  
Type Ii ◽  
Mineral Density ◽  
Cross Sectional

Introduction. The purpose of this study was to investigate body composition, muscle function, and muscle morphology in patients with spondyloarthritis (SpA).Methods. Ten male SpA patients (mean ± SD age39±4.1years) were compared with ten healthy controls matched for sex, age, body mass index, and self-reported level of physical exercise. Body composition was measured by dual energy X-ray absorptiometry. Musculus quadriceps femoris (QF) strength was assessed by maximal isometric contractions prior to test of muscular endurance. Magnetic resonance imaging of QF was used to measure muscle size and calculate specific muscle strength. Percutaneous needle biopsy samples were taken fromm. vastus lateralis.Results. SpA patients presented with significantly lower appendicular lean body mass (LBM) (p=0.02), but there was no difference in bone mineral density, fat mass, or total LBM. Absolute QF strength was significantly lower in SpA patients (p=0.03) with a parallel trend for specific strength (p=0.08). Biopsy samples from the SpA patients revealed significantly smaller cross-sectional area (CSA) of type II muscle fibers (p=0.04), but no difference in CSA type I fibers.Conclusions. Results indicate that the presence of SpA disease is associated with reduced appendicular LBM, muscle strength, and type II fiber CSA.

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