{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:10:21Z","timestamp":1747188621461,"version":"3.40.5"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007842","name":"Utenriksdepartementet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007842","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>New Findings<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p><jats:bold>What is the central question of this study?<\/jats:bold><\/jats:p>\n<jats:p>Mortality in accidental hypothermia patients rewarmed by extracorporeal circulation remains high. Knowledge concerning optimal fluid additions for extracorporeal rewarming is lacking, with no apparent consensus. Does colloid <jats:italic>versus<\/jats:italic> crystalloid priming have different effects on fluid balance and blood flow distribution during extracorporeal rewarming?<\/jats:p>\n<\/jats:list-item>\n<jats:list-item><jats:p><jats:bold>What is the main finding and its importance?<\/jats:bold><\/jats:p>\n<jats:p>In our rat model of extracorporeal rewarming from hypothermic cardiac arrest, hydroxyethyl starch generates less tissue oedema and increases circulating blood volume and organ blood flow, compared with saline. The composition of fluid additions appears to be important during extracorporeal rewarming from hypothermia.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Rewarming by extracorporeal circulation (ECC) is the recommended treatment for accidental hypothermia patients with cardiac instability. Hypothermia, along with initiation of ECC, introduces major changes in fluid homeostasis and blood flow. Scientific data to recommend best practice use of ECC for rewarming these patients is lacking, and no current guidelines exist concerning the choice of priming fluid for the extracorporeal circuit. The primary aim of this study was to compare the effects of different fluid protocols on fluid balance and blood flow distribution during rewarming from deep hypothermic cardiac arrest. Sixteen anaesthetized rats were cooled to deep hypothermic cardiac arrest and rewarmed by ECC. During cooling, rats were equally randomized into two groups: an extracorporeal circuit primed with saline or primed with hydroxyethyl starch (HES). Calculations of plasma volume (PV), circulating blood volume (CBV), organ blood flow, total tissue water content, global O<jats:sub>2<\/jats:sub> delivery and consumption were made. During and after rewarming, the pump flow rate, mean arterial pressure, PV and CBV were significantly higher in HES\u2010treated compared with saline\u2010treated rats. After rewarming, the HES group had significantly increased global O<jats:sub>2<\/jats:sub> delivery and blood flow to the brain and kidneys compared with the saline group. Rats in the saline group demonstrated a significantly higher total tissue water content in the kidneys, skeletal muscle and lung. Compared with crystalloid priming, the use of an iso\u2010oncotic colloid prime generates less tissue oedema and increases PV, CBV and organ blood flow during ECC rewarming. The composition of fluid additions appears to be an important factor during ECC rewarming from hypothermia.<\/jats:p><\/jats:sec>","DOI":"10.1113\/ep087786","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T11:54:40Z","timestamp":1561031680000},"page":"1353-1362","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Extracorporeal rewarming from experimental hypothermia: Effects of hydroxyethyl starch <i>versus<\/i> saline priming on fluid balance and blood flow distribution"],"prefix":"10.1113","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1767-0778","authenticated-orcid":false,"given":"Torstein","family":"Schanche","sequence":"first","affiliation":[{"name":"Anaesthesia and Critical Care Research Group Department of Clinical Medicine, UiT The Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timofei","family":"Kondratiev","sequence":"additional","affiliation":[{"name":"Anaesthesia and Critical Care Research Group Department of Clinical Medicine, UiT The Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6137-7790","authenticated-orcid":false,"given":"Torkjel","family":"Tveita","sequence":"additional","affiliation":[{"name":"Anaesthesia and Critical Care Research Group Department of Clinical Medicine, UiT The Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Division of Surgical Medicine and Intensive Care University Hospital of North Norway  Troms\u00f8 Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1114208"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0538-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181863117"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.1977.233.5.H605"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1969.27.5.592"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0b013e3181877a38"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cryobiol.2014.09.007"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cryobiol.2014.09.002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200009000-00007"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2006.01064.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.00103.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.10.006"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1975.114"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1959.39.2.307"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2004.11.020"},{"key":"e_1_2_7_17_1","first-page":"207","article-title":"Colloids versus crystalloids as priming solutions for cardiopulmonary bypass: A meta\u2010analysis of prospective, randomised clinical trials","volume":"54","author":"Himpe D.","year":"2003","journal-title":"Acta Anaesthesiologica Belgica"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11344"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-003-0557-0"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01229.2005"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2009.02156.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1957.tb05201.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1959.tb05479.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-88-470-5427-1_14"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1865-1380-5-7"},{"key":"e_1_2_7_26_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1051\/ject\/201749174","article-title":"Endothelial glycocalyx and cardiopulmonary bypass","volume":"49","author":"Myers G. 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