• Gergely H Fodor, Barna Babik, Dorottya Czövek, Camille Doras, Ádám L Balogh, Sam Bayat, Walid Habre, and Ferenc Peták.
• From the Department of Medical Physics and Informatics (GHF, DC, FP), Department of Anaesthesiology and Intensive Therapy, University of Szeged, Szeged, Hungary (BB, ÁLB), Pathophysiological Experimental Platform, Department of Anaesthesiology, Pharmacology and Intensive Care, University of Geneva (CD), Paediatric Anaesthesia Unit, Geneva Children's Hospital, University Hospitals of Geneva, Geneva, Switzerland (WH), and Université de Picardie Jules Verne, Inserm U1105 and Paediatric Lung Function Laboratory, CHU Amiens, Amiens, France (SB).
• Eur J Anaesthesiol. 2016 Jan 1; 33 (1): 34-41.

BackgroundFluid replacement with blood products, colloids and crystalloids is associated with morbidity and mortality. Despite this, the consequences of fluid administration on airway and respiratory tissue properties are not fully understood.ObjectiveComparison of respiratory effects of fluid replacement with autologous blood (Group B), colloid (HES 6% 130/0.4, Group CO) or crystalloid solution (NaCl 0.9%, Group CR) after haemorrhage with separate assessments of airway resistance and respiratory tissue mechanics.DesignA randomised study.SettingAn experimental model of surgical haemorrhage and fluid replacement in rats.ParticipantsAnaesthetised, ventilated rats randomly allocated into three groups (Group B: n = 8, Group CO: n = 8, Group CR: n = 9).InterventionAnimals were bled in six sequential steps, each manoeuvre targeting a loss of 5% of total blood volume. The blood loss was then replaced stepwise in a 1 : 1 ratio with one of the three fluids.Main Outcome MeasureAfter each step, airway resistance (Raw), tissue damping and elastance (H) were determined by forced oscillations. Oedema indices from lung weights and histology were also measured.ResultsRaw (mean ± SD) decreased in all groups following blood loss (-20.3 ± 9.5% vs. baseline, P < 0.05), and remained low following blood replacement (-21.7 ± 14.5% vs. baseline, P < 0.05), but was normalised by colloid (5.5 ± 10.7%, NS). Crystalloid administration exhibited an intermediate reversal effect (-8.4 ± 14.7%, NS). Tissue viscoelasticity increased following both blood loss and replacement, with no evidence of a significant difference in H between Groups CO and CR. More severe oedema was observed in Groups CR and CO than in Group B (P < 0.05), with no difference between the colloid and crystalloid solutions.ConclusionThis model, which mimics surgical haemorrhage, yields no evidence of a difference between colloids and crystalloids with regard to the pulmonary consequences of blood volume restoration. Functional changes in the lung should not be a key concern when choosing fluid replacement therapy with these solutions.

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