Polyethylene Glycol Polymers in Low Volume Resuscitation
Technical Report,30 Sep 2017,29 Sep 2018
Virginia Commonwealth University Richmond United States
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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 mgml 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 mgml. 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.
- Medicine and Medical Research