Document Detail


Plasma volume replacement with HES 130/0.42 obviates negative side effects of pneumoperitoneum in piglets.
MedLine Citation:
PMID:  18647273     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Evidence-based guidelines on optimal perioperative fluid management in infants have not been established. Recent randomized trials in major abdominal surgery in adults suggest that large volumes of fluid may increase morbidity and hospital stay. Our own clinical experience in infants undergoing laparoscopic surgery is different. So the aim of this study was to compare a crystalloid vs a plasma volume stabilizing fluid management regime during prolonged pneumoperitoneum (PP) in an experimental setting. METHODS: Fifteen German landrace piglets were randomized to one of the following treatment groups: control (no PP, 5 ml x kg(-1) x h(-1) electrolyte solution); crystalloid (180 min of PP, 5 ml x kg(-1) x h(-1) electrolyte solution); colloid (180 min of PP, single bolus of 5 ml x kg(-1) followed by 5 ml x kg(-1) x h(-1) hydroxyethyl starch 130/0.42/6:2). After decompression, monitoring was continued for a further 120 min. During the investigation, the hemodynamic situation including transpulmonary thermodilution and blood gases was monitored periodically. RESULTS: During the study, mean arterial pressure remained within the normal range in colloid-treated animals and controls, but was significantly lower in crystalloid-treated animals after decompression of PP. Cardiac output remained within the normal range in the colloid and control groups, but decreased in the crystalloid-treated animals. In the crystalloid group, the lactate concentrations were higher and base excess was lower than in the colloid and control groups at 240 and 300 min (study end). CONCLUSION: This study shows that the negative effects of prolonged PP on hemodynamics and acid-base balance can be obviated by a liberal plasma volume stabilization regimen with colloids.
Authors:
Wilhelm Alexander Osthaus; Dirk Huber; Christoph Bäumker; Lars Witt; Martin Metzelder; Jochen Kuebler; Robert Sümpelmann
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-07-21
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  18     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-24     Completed Date:  2009-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  922-8     Citation Subset:  IM    
Affiliation:
Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Germany. osthaus.alexander@mh-hannover.de
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MeSH Terms
Descriptor/Qualifier:
Animals
Bicarbonates / blood
Blood Pressure / physiology
Cardiac Output / physiology
Fluid Therapy*
Heart Rate / physiology
Hetastarch / therapeutic use*
Lactic Acid / blood
Plasma Substitutes / therapeutic use*
Plasma Volume / drug effects*
Pneumoperitoneum, Artificial / adverse effects*,  methods
Random Allocation
Sodium Chloride / pharmacology
Swine
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Plasma Substitutes; 50-21-5/Lactic Acid; 7647-14-5/Sodium Chloride; 9005-27-0/Hetastarch

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