Brecher M E, Owen H G
Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, USA.
J Clin Apher. 1996;11(3):123-6. doi: 10.1002/(SICI)1098-1101(1996)11:3<123::AID-JCA1>3.0.CO;2-D.
Colloidal starch has been used safely as a plasma expander and an erythrocyte sedimenting agent for over 25 years. However, there remains some concern in regard to the long term sequelae of the administration of large volumes of colloid starch such as would be administered if colloidal starch were used as a plasma replacement during serial plasma exchanges. We identified mathematical relations that allowed for the calculations of the theoretical circulating residual starch in a patient undergoing serial plasma exchanges and used it to model a variety of possible clinical scenarios. Following six one plasma volume exchanges, one would expect only 11, 13, 14, or 17% of the total infused starch to be remaining in the circulation. For example, in the case of a 4L exchange with full replacement, only the starch in 4.1 liters (4L x 6 exchanges x 17% = 4.1L) would be expected to remain in the circulation despite an infusion of 24 L (4L x 6 exchanges = 24L) of starch. The results suggest that relatively small amounts of starch would be expected to remain circulating relative to the large amounts infused following a series of plasma exchanges with partial or full starch replacement.
胶体淀粉作为血浆扩容剂和红细胞沉降剂已安全使用超过25年。然而，对于大量输注胶体淀粉的长期后遗症仍存在一些担忧，例如在连续血浆置换过程中使用胶体淀粉作为血浆替代品时可能会大量输注。我们确定了数学关系，可用于计算接受连续血浆置换患者体内理论循环残留淀粉量，并将其用于模拟各种可能的临床情况。在进行六次一个血浆量的置换后，预计循环中残留的输注淀粉总量仅为11%、13%、14%或17%。例如，在进行4升全量置换的情况下，尽管输注了24升（4升×6次置换 = 24升）淀粉，但预计循环中仅残留4.1升（4升×6次置换×17% = 4.1升）淀粉中的淀粉。结果表明，在部分或全部用淀粉置换的一系列血浆置换后，相对于大量输注的淀粉而言，预计循环中残留的淀粉量相对较少。
