Fat Autograph Retention: Use of Albumin to Correct Physiologic Perturbation Caused by Klein Solution

2007 ◽  
Vol 24 (3) ◽  
pp. 123-134 ◽  
Author(s):  
Mitchell V. Kaminski ◽  
Rose Lopez de Vaughan
Keyword(s):  
Stem Cells ◽  
Osmotic Pressure ◽  
Protein Concentration ◽  
Interstitial Fluid ◽  
Retention Rate ◽  
Dilution Effect ◽  
Colloid Osmotic Pressure ◽  
Fat Grafting ◽  
Fat Harvesting ◽  
Tumescent Solution

Introduction: Correction of the dilution effect of Kline Solution on colloid osmotic pressure in fat harvested for autografting may be an important factor in enhancing graft viability. The specific deficit is an acute decrease in interstitial soluble protein concentration as tumescent solution is infiltrated for local anesthesia. The most important protein component creating colloid osmotic pressure in interstitial fluid is albumin. Thus, the commercial availability of human serum albumin makes correction of this physiologic perturbation easily accomplished by the addition of 1 ml of albumin per 10-ml fat-harvesting syringe. Materials and Methods: Review of the literature and description of technique. Results: The steps to ensure fat autograph retention include: harvest using small cannulas (16- or 18-gauge), restore colloid pressure using albumin in the collection syringe, inject the graft with relatively atraumatic needles (modified 18- or 22-gauge needles), and inject the fat to produce a trail of small beads in multiple fine layers with each bead touching the nutrient bed. Discussion: The study of fat grafting continues to evolve. As it does, the science behind graft has led to better understanding of the adipocyte as a member of a dynamic organ with endocrine, apocrine, and paracrine functions. The fat mass is dynamic. Adipocyte number is not as stagnant as previously thought. They can differentiate and dedifferentiate and become stem cells with the potential to become bone, cartilage, fat and nerve cells. Stem cells from lipo-aspirate make more sense than bone marrow or embryonic sources. For one thing, fat is easy to obtain, and when used in the same patient its endogenous genetic code is identical, removing another obstacle to retention. Conclusion: These observations are reported here as they seem to result in a nearly 90% graft retention rate and reduce the need to overfill.

Quantitation of changes in lymph protein concentration during lymph node transit

1982 ◽  
Vol 243 (3) ◽  
pp. H351-H359 ◽  
Author(s):  
T. H. Adair ◽  
D. S. Moffatt ◽  
A. W. Paulsen ◽  
A. C. Guyton
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Osmotic Pressure ◽  
Protein Concentration ◽  
Interstitial Fluid ◽  
Colloid Osmotic Pressure ◽  
Free Fluid ◽  
Low Protein ◽  
Afferent Lymph

Many investigators assume the protein concentration and colloid osmotic pressure of interstitial fluid and lymph to be identical even after the lymph has passed through a lymph node. We quantitated the degree of modification of lymph by the dog popliteal lymph node by perfusing isolated lymph nodes in situ at physiological flow rates with homologous plasma or plasma diluted to low protein concentration. This enabled us to compare directly prenodal and postnodal lymph flows and protein concentrations. When undiluted plasma was infused into the node, fluid filtered from the blood into the lymph, diluting the lymph. When diluted plasma was infused, fluid was absorbed from the lymph, concentrating the lymph. Nearly all (98%) of the change in lymph protein concentration could be explained by transfer of protein-free fluid either into or out of the lymph. However, when the nodes were perfused with lymph having a colloid osmotic pressure that exactly balanced the hydrostatic and osmotic forces acting across the lymph node blood-lymph barrier, the lymph was not modified during nodal transit. This "equilibrium colloid osmotic pressure" averaged 60% of that of plasma. The concentrating-diluting mechanism became more significant as the perfusion rate decreased and/or as the colloid osmotic pressure of the afferent lymph was made progressively greater than or less than the equilibrium colloid osmotic pressure. We conclude that lymph nodes modify lymph protein concentration and colloid osmotic pressure except when these are already at equilibrium values for given lymph node conditions. Therefore, the assumption that postnodal lymph is representative of interstitial fluid, especially at low but still physiological lymph flows, is likely to be incorrect.

Isolation of pulmonary interstitial fluid in rabbits by a modified wick technique

2001 ◽  
Vol 280 (5) ◽  
pp. L1057-L1065 ◽  
Author(s):  
Daniela Negrini ◽  
Alberto Passi ◽  
Katia Bertin ◽  
Federica Bosi ◽  
Helge Wiig
Keyword(s):  
Osmotic Pressure ◽  
Plasma Proteins ◽  
Regional Differences ◽  
Protein Concentration ◽  
Interstitial Fluid ◽  
Lung Parenchyma ◽  
Colloid Osmotic Pressure ◽  
Rabbit Lung ◽  
Pressure Plasma ◽  
Wick Technique

Interstitial fluid protein concentration (Cprotein) values in perivascular and peribronchial lung tissues were never simultaneously measured in mammals; in this study, perivascular and peribronchial interstitial fluids were collected from rabbits under control conditions and rabbits with hydraulic edema or lesional edema. Postmortem dry wicks were implanted in the perivascular and peribronchial tissues; after 20 min, the wicks were withdrawn and the interstitial fluid was collected to measure Cprotein and colloid osmotic pressure. Plasma, perivascular, and peribronchial Cproteinvalues averaged 6.4 ± 0.7 (SD), 3.7 ± 0.5, and 2.4 ± 0.7 g/dl, respectively, in control rabbits; 4.8 ± 0.7, 2.5 ± 0.6, and 2.4 ± 0.4 g/dl, respectively, in rabbits with hydraulic edema; and 5.1 ± 0.3, 4.3 ± 0.4 and 3.3 ± 0.6 g/dl, respectively, in rabbits with lesional edema. Contamination of plasma proteins from microvascular lesions during wick insertion was 14% of plasma Cprotein. In control animals, pulmonary interstitial Cprotein was lower than previous estimates from pre- and postnodal pulmonary lymph; furthermore, although the interstitium constitutes a continuum within the lung parenchyma, regional differences in tissue content seem to exist in the rabbit lung.

Isolation of rat trachea interstitial fluid and demonstration of local cytokine production in lipopolysaccharide-induced systemic inflammation

2008 ◽  
Vol 104 (3) ◽  
pp. 809-820 ◽  
Author(s):  
Elvira Semaeva ◽  
Olav Tenstad ◽  
Athanasia Bletsa ◽  
Eli-Anne B. Gjerde ◽  
Helge Wiig
Keyword(s):  
Bronchoalveolar Lavage ◽  
Osmotic Pressure ◽  
Protein Concentration ◽  
Interstitial Fluid ◽  
Bronchoalveolar Lavage Fluid ◽  
Protein Pattern ◽  
Fluid Phase ◽  
Lavage Fluid ◽  
Colloid Osmotic Pressure ◽  
High Protein Concentration

Access to interstitial fluid from trachea is important for understanding tracheal microcirculation and pathophysiology. We tested whether a centrifugation method could be applied to isolate this fluid in rats by exposing excised trachea to G forces up to 609 g. The ratio between the concentration of the equilibrated extracellular tracer 51Cr-labeled EDTA in fluid isolated at 239 g and plasma averaged 0.94 ± 0.03 ( n = 14), suggesting that contamination from the intracellular fluid phase was negligible. The protein pattern of the isolated fluid resembled plasma closely and had a protein concentration 83% of that in plasma. The colloid osmotic pressure in the centrifugate in controls ( n = 5) was 18.8 ± 0.6 mmHg with a corresponding pressure in plasma of 22 ± 1.5 mmHg, whereas after overhydration ( n = 5) these pressures fell to 9.8 ± 0.4 and 11.9 ± 0.4 mmHg, respectively. We measured inflammatory cytokine concentration in serum, interstitial fluid, and bronchoalveolar lavage fluid in LPS-induced inflammation. In control animals, low levels of IL-1β, IL-6, and TNF-α in serum, trachea interstitial fluid, and bronchoalveolar lavage fluid were detected. LPS resulted in a significantly higher concentration in IL-1β and IL-6 in interstitial fluid than in serum, showing a local production. To conclude, we have shown that interstitial fluid can be isolated from trachea by centrifugation and that trachea interstitial fluid has a high protein concentration and colloid osmotic pressure relative to plasma. Trachea interstitial fluid may also reflect lower airways and thus be of importance for understanding, e.g., inflammatory-induced airway obstruction.

Transcapillary Starling forces using membrane osmometry

1980 ◽  
Vol 238 (6) ◽  
pp. H886-H888
Author(s):  
J. L. Christian ◽  
R. A. Brace
Keyword(s):  
Osmotic Pressure ◽  
Interstitial Fluid ◽  
Subcutaneous Tissue ◽  
Fluid Pressure ◽  
Colloid Osmotic Pressure ◽  
Interstitial Fluid Pressure ◽  
Tissue Samples ◽  
Small Pore ◽  
The Difference ◽  
Good Agreement

Membrane osmometry was used to estimate the four transcapillary Starling pressures in subcutaneous tissue of rats, guinea pigs, and dogs. Isolated subcutaneous tissue samples were either placed on a large-pore or small-pore osmometer that measured the interstitial fluid pressure (Pif) and the difference between the interstitial fluid pressure and the interstitial protein osmotic pressure (Pif-pi if), respectively. The colloid osmotic pressure of the interstitial fluid (pi if) was obtained from the difference in these two pressures. A plasma sample placed on the small-pore osmometer yielded the colloid osmotic pressure of the plasma proteins (pi c). Finally the capillary pressure (Pc) was calculated from the three other Starling forces. In the rat, guinea pig, and dog, respectively, the estimated Starling forces were as follows: Pif -2.2, -2.1, and -4.8 mmHg; pi if, 7.3, 4.8, and 4.4 mmHg; pi c, 21.3, 19.5, and 19.2 mmHg; and Pc, 11.8, 12.6, and 10.0 mmHg. A comparison with data obtained in other studies using different methods shows good agreement and strongly supports membrane osmometry as a method for measuring the Starling pressures in subcutaneous tissue.

scholarly journals Plasma proteins in growing analbuminaemic rats fed on a diet of low-protein content

1989 ◽  
Vol 61 (3) ◽  
pp. 485-494 ◽  
Author(s):  
J. A. Joles ◽  
E. H. J. M. Jansen ◽  
C. A. Laan ◽  
N. Willekes-Koolschijn ◽  
W. Kortlandt ◽  
...  
Keyword(s):  
Body Weight ◽  
Osmotic Pressure ◽  
Plasma Protein ◽  
Protein Concentration ◽  
Extracellular Fluid ◽  
Colloid Osmotic Pressure ◽  
Protein Diet ◽  
Sprague Dawley ◽  
Plasma Protein Concentration ◽  
Low Protein

1. Analbuminaemic and Sprague-Dawley (control) rats were fed on low- (60 g/kg) protein and control (200 g protein/kg) dietsad lib.from weaning. Males and females were studied separately. Body-weight and plasma protein concentrations were determined at 10 d intervals from 25 to 75 d of age. Electrophoresis of plasma proteins was performed in samples from day 75. Extracellular fluid volume was measured at 10 d intervals from day 45 onwards. Colloid osmotic pressure was measured in plasma and interstitial fluid (wick technique) at the start and end of the trial.2. Body-weight increased much less on the low-protein diet than on the normal diet in both strains and sexes. The growth retardation was slightly more pronounced in the male analbuminaemic rats than in the male Sprague-Dawley controls.3. Plasma protein concentration increased during normal growth in all groups, particularly in the female analbuminaemic rats. This increase was reduced by the 60 g protein/kg diet in all groups, with the exception of the male analbuminaemic rats.4. Differences in plasma colloid osmotic pressure were similar to those seen in plasma protein concentration. Interstitial colloid osmotic pressure was higher in the control rats than in the analbuminaemic ones. The interstitial colloid osmotic pressure increased during growth in the control but not in the analbuminaemic rats. The difference in interstitial colloid osmotic pressure between the strains was maintained during low-protein intake, but at a lower level than during normal protein intake.5. Subtracting interstitial from plasma colloid osmotic pressure, resulted in a rather similar transcapillary oncotic gradient in the various groups at 75 d, both on the control protein diet (11–14 mmHg), and on the lowprotein diet (9–11 mmHg).6. All protein fractions were reduced to a similar extent by the low-protein diet in the control rats, whereas in the analbuminaemic rats protein fractions produced in the liver were more severely depressed.7. Extracellular fluid volume as a percentage of body-weight was similar in all groups, and decreased with increasing age.8. In conclusion, the analbuminaemic rats were able to maintain the transcapillary oncotic gradient on both diets by reducing the interstitial colloid osmotic pressure. Oedema was not observed.9. Despite the absence of albumin, the protein-malnourished analbuminaemic rat is no more susceptible to hypoproteinaemia and oedema than its normal counterpart.

scholarly journals The Colloid Osmotic Pressure Across the Glycocalyx: Role of Interstitial Fluid Sub-Compartments in Trans-Vascular Fluid Exchange in Skeletal Muscle

2021 ◽  
Vol 9 ◽  
Author(s):  
Fitzroy E. Curry ◽  
C. Charles Michel
Keyword(s):  
Skeletal Muscle ◽  
Steady State ◽  
Osmotic Pressure ◽  
Capillary Pressure ◽  
Interstitial Fluid ◽  
Protein Composition ◽  
Colloid Osmotic Pressure ◽  
Endothelial Glycocalyx ◽  
Fluid Exchange ◽  
Small Pore

The primary purpose of these investigations is to integrate our growing knowledge about the endothelial glycocalyx as a permeability and osmotic barrier into models of trans-vascular fluid exchange in whole organs. We describe changes in the colloid osmotic pressure (COP) difference for plasma proteins across the glycocalyx after an increase or decrease in capillary pressure. The composition of the fluid under the glycocalyx changes in step with capillary pressure whereas the composition of the interstitial fluid takes many hours to adjust to a change in vascular pressure. We use models where the fluid under the glycocalyx mixes with sub-compartments of the interstitial fluid (ISF) whose volumes are defined from the ultrastructure of the inter-endothelial cleft and the histology of the tissue surrounding the capillaries. The initial protein composition in the sub-compartments is that during steady state filtration in the presence of a large pore pathway in parallel with the “small pore” glycocalyx pathway. Changes in the composition depend on the volume of the sub-compartment and the balance of convective and diffusive transport into and out of each sub-compartment. In skeletal muscle the simplest model assumes that the fluid under the glycocalyx mixes directly with a tissue sub-compartment with a volume less than 20% of the total skeletal muscle interstitial fluid volume. The model places limits on trans-vascular flows during transient filtration and reabsorption over periods of 30–60 min. The key assumption in this model is compromised when the resistance to diffusion between the base of the glycocalyx and the tissue sub-compartment accounts for more than 1% of the total resistance to diffusion across the endothelial barrier. It is well established that, in the steady state, there can be no reabsorption in tissue such as skeletal muscle. Our approach extends this idea to demonstrate that transient changes in vascular pressure favoring initial reabsorption from the interstitial fluid of skeletal muscle result in much less fluid exchange than is commonly assumed. Our approach should enable critical evaluations of the empirical models of trans-vascular fluid exchange being used in the clinic that do not account for the hydrostatic and COPs across the glycocalyx.

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