{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:37:42Z","timestamp":1791128262483,"version":"4.1.0"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Intravascular volume replacement is often required in the presence of increased pulmonary capillary leakage, for example in patients with volutrauma with major hemorrhage. In the present study, the effects of Ringer\u2019s acetate (RA), gelatin-polysuccinate (GEL), and a modern hydroxyethyl starch (HES, 6% 130\/0.42) on lung and kidney function and damage were compared in a two-hit model of acute lung injury. The authors hypothesized that GEL and HES, compared to RA: (1) reduced lung histological damage, (2) impaired kidney morphology and function.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Acute lung injury was induced in 30 anesthetized pigs by tidal volumes approximately 40 ml\/kg, after saline lung lavage. Protective ventilation was initiated and approximately\u224825% of estimated blood volume was drawn. Animals were randomly assigned to receive RA, GEL, or HES (n = 10\/group) aimed at approximately 90% of intrathoracic blood volume before blood drainage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Fluid volumes were higher with RA (2,250 \u00b1 764 ml) than GEL (704 \u00b1 159 ml) and HES (837 \u00b1 82 ml) (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). Compared to RA, HES reduced diffuse alveolar damage overall, and GEL in nondependent zones only. GEL and HES yielded lower wet-to-dry ratios compared to RA (6.5 \u00b1 0.5 and 6.5 \u00b1 0.6 <jats:italic toggle=\"yes\">vs<\/jats:italic>. 7.9 \u00b1 0.9, respectively, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05). HES and RA resulted in less kidney damage than GEL, but kidney function did not differ significantly among groups. Compared to GEL, HES yielded lower lung elastance (55 \u00b1 12 <jats:italic toggle=\"yes\">vs<\/jats:italic>. 45 \u00b1 13 cm H<jats:sub>2<\/jats:sub>O\/l, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05) and intra-abdominal pressure (15 \u00b1 5 <jats:italic toggle=\"yes\">vs<\/jats:italic>. 11 \u00b1 4 cm 14;H<jats:sub>2<\/jats:sub>O, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In this model of acute lung injury, intravascular volume expansion after major hemorrhage with HES yielded less lung damage than RA and less kidney damage than GEL.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/aln.0b013e31827e554c","type":"journal-article","created":{"date-parts":[[2012,12,22]],"date-time":"2012-12-22T04:00:16Z","timestamp":1356148816000},"page":"395-408","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":29,"title":["Effects of Intravascular Volume Replacement on Lung and Kidney Function and Damage in Nonseptic Experimental Lung Injury"],"prefix":"10.1097","volume":"118","author":[{"given":"Pedro L.","family":"Silva","sequence":"first","affiliation":[{"name":"Research Fellow, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Therapy, University Hospital Dresden, Dresden, Germany, and Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"G\u00fcldner","sequence":"additional","affiliation":[{"name":"Resident Anesthesiologist and Research Fellow, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Uhlig","sequence":"additional","affiliation":[{"name":"Research Fellow, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Dresden University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadja","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Assistant Professor, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, and Postgraduate Electrical Engineering Program, Federal University of Par\u00e1, Bel\u00e9m, Par\u00e1, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Beda","sequence":"additional","affiliation":[{"name":"Laboratory Staff, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Dresden University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Rentzsch","sequence":"additional","affiliation":[{"name":"Professor, Institute of Anatomy, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kasper","sequence":"additional","affiliation":[{"name":"Senior Statistician, Associate Professor, Institute for Medical Informatics and Biometry, Dresden, University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e4rbel","family":"Wiedemann","sequence":"additional","affiliation":[{"name":"Resident Anesthesiologist, Research Fellow, Pulmonary Engineering Group, Department, of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Spieth","sequence":"additional","affiliation":[{"name":"Professor and Chair, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Dresden University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thea","family":"Koch","sequence":"additional","affiliation":[{"name":"Professor, Pulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Dresden University of Technology, Dresden, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera L.","family":"Capelozzi","sequence":"additional","affiliation":[{"name":"Professor, Department of Pathology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pelosi","sequence":"additional","affiliation":[{"name":"Professor, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, IRCCS San Martino-IST, Genoa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia R. 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