Polyethylene Glycol Polymers in Low Volume Resuscitation
Abstract
The effectiveness of polyethylene glycol (PEG) based low volume resuscitation (LVR) solution sis dependent on polymer size, which correlated with their distribution in the microcirculation. Specifically, PEG-20k (MW 20,000) produced optimal resuscitation outcomes compared to smaller or larger polymer sizes. Shocked rats resuscitated with PEG-20k all survived 24 hours (100 percent) compared to saline volume controls (0 percent) and had brain function scores comparable to sham controls after recovery from shock. PEG-20k was mainly excreted by the kidneys with a half-life of about 6 hrs. Maximum PEG-20k blood levels (3 mg/ml) were 3times lower than the lowest dose that produced a mild coagulopathy in ex-vivo blood testing using TEG in volunteers or trauma patients (10 mg/ml). Further coagulation and platelet function studies suggest the mild coagulopathy with higher doses of PEG LVR solutions is due to nonspecific platelet passivation, probably by surface binding, but is clinically moot at currently used concentrations in shock.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2018
- Accession Number
- AD1093655
Entities
People
- Martin J Mangino
Organizations
- Virginia Commonwealth University