Document Detail


Replacement of major surgical blood loss by hypo-oncotic or conventional plasma substitutes.
MedLine Citation:
PMID:  7540789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the study was to examine the effects of hypooncotic 4% hydroxyethyl starch 120/0.7, 3% dextran 70, 5% albumin and hyperoncotic 6% hydroxyethyl starch 120/0.7 on the perioperative colloid osmotic pressure (COP), albumin and protein concentrations and fluid balance. The plasma substitutes were used with red cell concentrates to replace blood loss with equal volume in sixty major abdominal or urological surgeries. A special effort was made to keep replacements and losses at even volumes constantly and to avoid fluctuation of blood volume. The blood specimen were obtained before induction, after each 20% blood loss, at the end of the recovery room phase and on the three following postoperative mornings. There were significant differences in the peroperative and immediate postoperative COPs. However, these differences had vanished by the first postoperative morning. COP was preserved above 16 mmHg in all groups throughout the study. The identical peroperative albumin and protein concentrations of the synthetic colloid groups suggests that their volume effect was the same, regardless of the varying COP. During the observation period there were no significant differences among the groups concerning the diuresis and the fluid balances. We conclude, that the hypooncotic 4% HES 120 and 3% dextran 70 solutions provide the same clinical effect as 6% HES 120 solution. Consequently less colloid is needed, which allows the use of greater volumes of the dilute colloid solutions in replacement therapy.
Authors:
S Hiippala; K Linko; G Myllylä; M Lalla; R Hekali; A Mäkeläinen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  39     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-07-25     Completed Date:  1995-07-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  228-35     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Clinical Laboratory, Helsinki University Central Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery
Albumins / administration & dosage,  therapeutic use
Blood Loss, Surgical / prevention & control*
Blood Proteins / analysis
Blood Volume
Colloids
Dextrans / administration & dosage,  therapeutic use
Erythrocyte Transfusion
Female
Hematocrit
Hetastarch / administration & dosage,  therapeutic use
Humans
Male
Middle Aged
Osmotic Pressure
Plasma Substitutes / administration & dosage,  chemistry,  therapeutic use*
Serum Albumin / analysis
Urinary Tract / surgery
Water-Electrolyte Balance
Chemical
Reg. No./Substance:
0/Albumins; 0/Blood Proteins; 0/Colloids; 0/Plasma Substitutes; 0/Serum Albumin; 9004-54-0/Dextrans; 9005-27-0/Hetastarch

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