cytopempsis: the reason crystalloid : blood ratio not 3:1 any more?

Started by jean, April 14, 2010, 12:31:07 PM

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jean

hi, do anyone of u read "anesthesiology"  by Longnecker?
i am quiet interested by the term cytopempsis mentioned in that book...it is interesting because the book is telling us that the cytopempsis is the reason for giving more crystalloid for blood loss ratio..but i don't understand this term quiet well,

i don't understand why increasing extracellular space more compliant would increase the transcapilllary leakage ? shouldn't increasing the extracellular space volume would increase the interstitial hydrostatic pressure?

i have searched in other sources but i can't find anything about this ...could please someone explain it to me? thx u so much :)

here i quote how the book explained about this term

QuoteTraditional approaches to blood replacement have identified a 3:1 ratio of crystalloid to blood loss. This is incorrect. With increasing volumes of crystalloid administration the extracellular space becomes progressively more compliant, resulting in a geometric increase in transcapillary leakage
that volume replacement for blood loss parallels. This process is known
as cytopempsis and principally reflects the progressive hypoalbuminemia associated with volume replacement.