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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Medicina 2017, 53(4), 233-241; https://doi.org/10.1016/j.medici.2017.07.005 (registering DOI)

Influences of red blood cell and platelet counts on the distribution and elimination of crystalloid fluid

Research Unit, Södertälje Hospital, Södertälje, Sweden
Received: 13 September 2016 / Revised: 31 March 2017 / Accepted: 17 July 2017 / Published: 3 August 2017
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Abstract

Background and objective: A high number of blood cells increases the viscosity of the blood. The present study explored whether variations in blood cell counts are relevant to the distribution and elimination of infused crystalloid fluid.
Materials and methods: On three different occasions, 10 healthy male volunteers received an intravenous infusion of 25 mL/kg of Ringer's acetate, Ringer's lactate, and isotonic saline over 30 min. Blood hemoglobin and urinary excretion were monitored for 4 h and used as input in a two-volume kinetic model, using nonlinear mixed effects software. The covariates used in the kinetic model were red blood cell and platelet counts, the total leukocyte count, the use of isotonic saline, and the arterial pressure.
Results: Red blood cell and platelet counts in the upper end of the normal range were associated with a decreased rate of distribution and redistribution of crystalloid fluid. Simulations showed that high counts were correlated with volume expansion of the peripheral (interstitial) fluid space, while the plasma volume was less affected. In contrast, the total leukocyte count had no influence on the distribution, redistribution, or elimination. The use of isotonic saline caused a transient reduction in the systolic arterial pressure (P < 0.05) and doubled the half-life of infused fluid in the body when compared to the two Ringer solutions. Isotonic saline did not decrease the serum potassium concentration, despite the fact that saline is potassium-free.
Conclusions: High red blood cell and platelet counts are associated with peripheral accumulation of infused crystalloid fluid.
Keywords: Fluid therapy; Pharmacokinetics; Erythrocyte count; Platelet count; Isotonic saline Fluid therapy; Pharmacokinetics; Erythrocyte count; Platelet count; Isotonic saline
This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License (CC BY-NC-ND) (CC BY-NC-ND).

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Hahn, R.G. Influences of red blood cell and platelet counts on the distribution and elimination of crystalloid fluid. Medicina 2017, 53, 233-241.

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