losartan-potassium and Dehydration

Erythropoietin (EPO) is a hematopoietic growth factor and an alternative to avoid blood transfusion in high-blood-loss surgeries. We evaluate EPO efficacy to reduce clinically relevant anemia and dehydration in patients undergoing liposuction.. We prospectively evaluated 50 consecutive patients subjected to liposuction greater than 2.5 L and alternately assigned into two comparable groups (25 patients each), except for the postoperative administration of erythropoietin (4000 UI per day subcutaneously) during five consecutive days. Incidence data for blood transfusion or parenteral hydration were collected. Statistical analyses were performed with significance at p value <5%.. There was no significant difference between groups related to any preoperative feature or the incidence of dehydration (p = 0.1099) or transfusion (p = 1.0).. Postoperative erythropoietin administration was not effective in preventing blood transfusion for anemia or parenteral hydration for hemodynamic instability in patients undergoing major liposuction.. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

Topics: Abdominoplasty; Adult; Aged; Anemia; Blood Transfusion; Body Mass Index; Case-Control Studies; Combined Modality Therapy; Dehydration; Erythropoietin; Female; Follow-Up Studies; Hemodynamics; Humans; Injections, Subcutaneous; Lipectomy; Middle Aged; Postoperative Care; Prospective Studies; Reference Values; Treatment Outcome; Young Adult

The object of the present study was to evaluate the physiologic mechanisms regulating erythropoiesis by monitoring the changes in reticulocyte count in the circulation and the formation of erythroblastic islands in the bone marrow following hypertransfusion and dehydration. Forty-eight male Wistar rats (110-130 grams) were transfused with 70% isogenic suspension of washed and packed red cells at a dose of 2.5 ml/100 g body weight intravenously on two consecutive days (absolute erythrocytosis) or deprived of water for three days to produce relative erythrocytosis and then injected i.v. with saline at a dose of 2.5 ml/100 g body weight with water provided at libitum. Hematocrit was measured using the microhematocrit method. Reticulocytes were enumerated using the new methylene blue stain. Plasma EPO levels were measured radioimmunologically and a bone marrow suspension was prepared for morphological examination and absolute erythroblastic islands determination. We observed a marked suppression of erythropoiesis following the transfusion as evidenced by the elevation in hematocrit values up to 0.64 +/- 0.04, a decrease in reticulocyte count and plasma EPO reduction--13.5 +/- 3.4 mU/ml (P < 0.05) and a suppression of EO formation in the bone marrow (P < 0.01). The hematocrit of the dehydrated rats was elevated during the first 24 hours (P < 0.001). Reticulocytes, as well as EO, decreased on day 3 down do 53.6 x 10(9)/l +/- 9.8 x 10(9)/l (P < 0.001) and 153.6 x 10(3) +/- 21.5 x 10(3)/femur (P < 0.001), respectively. The EPO level was measured simultaneously--16.3 +/- 4.2 mU/ml versus 24.6 +/- 5.3 mU/ml at day 1 (P < 0.001). Following rehydration, a fast increase in the hematocrit value with a concomitant increase in EO and the reticulocyte counts was observed. Our results show that the absolute and relative changes in hematocrit values are paramount in the feedback mechanism for erythroid homeostasis.

Topics: Animals; Bone Marrow; Dehydration; Erythroblasts; Erythrocyte Transfusion; Erythropoiesis; Erythropoietin; Hematocrit; Male; Rats; Rats, Wistar; Reticulocyte Count

Radioiron uptake by erythrocytes, metabolic rate, erythropoietin formation during hypoxia and erythroid responsiveness to exogenous erythropoietin were determined in both starved and water deprived rats. The feed intake showed a marked and progressive reduction during water deprivation. The metabolic rates of rats deprived of either food of water declined progressively showing a 40% reduction 5d after water deprivation or starvation began. At this time, the 24 h red blood cells 59Fe incorporation was 85% lower in both starved and dehydrated rats than in normal rats. Plasma erythropoietin levels in response to hypoxia were approximately 50% decreased in both starved and dehydrated rats. Both polycythaemic starved and polycythaemic water deprived rats injected with human urinary erythropoietin showed a 75% decrease in 59Fe incorporation into erythrocytes when compared to control rats. It is suggested that depression of erythropoiesis during water deprivation in the rat depends on a reduced sensitivity to erythropoietin, possibly associated with decreased production of the hormone. Since water deprived rats drastically reduce feed intake it is suggested that secondary starvation is the principal cause of the decreased erythropoiesis induced in the rat by water deprivation.

Topics: Animals; Dehydration; Energy Metabolism; Erythropoiesis; Erythropoietin; Female; Hypoxia; Male; Polycythemia; Rats; Starvation; Water Deprivation

Topics: Anemia; Animals; Atmospheric Pressure; Blood Volume; Dehydration; Erythrocytes; Erythropoiesis; Erythropoietin; Hypoxia; Iron Isotopes; Polycythemia; Rats; Starvation

Topics: Animals; Blood Transfusion; Blood Volume; Dehydration; Erythropoiesis; Erythropoietin; Hematocrit; Humans; Hypoxia; Methemoglobin; Mice; Nitrites; Oxidoreductases; Oxygen

Topics: Animals; Biological Assay; Dehydration; Erythropoiesis; Erythropoietin; Fasting; Female; Heme; Iron; Iron Isotopes; Polycythemia; Rats; Skin; Skin Physiological Phenomena; Spectrophotometry; Talc; Tissue Extracts; Turpentine

Topics: Adult; Aged; Animals; Blood Cell Count; Blood Platelets; Blood Volume; Bone Marrow Cells; Dehydration; Duodenal Ulcer; Erythrocyte Count; Erythropoietin; Hematocrit; Hemodynamics; Hemoglobinopathies; Humans; Hypoxia; Iron Isotopes; Kidney Neoplasms; Leukocyte Count; Lung Diseases; Male; Mice; Middle Aged; Obesity Hypoventilation Syndrome; Oxygen; Oxygen Consumption; Phosphorus Isotopes; Plasma Volume; Polycythemia; Polycythemia Vera; Pulmonary Emphysema