Document Detail


Resuscitation in hypovolemia and shock: a prospective study of hydroxyethyl starch and albumin.
MedLine Citation:
PMID:  6190616     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a prospective study comprising 50 patients, we evaluated the hemodynamic, pulmonary, renal and coagulation changes after resuscitation with 2 colloidal fluids, 6% hydroxyethyl starch (HES) and 5% albumin (ALB). Twenty-five patients studied in each group were well matched for age, clinical presentation, presence of shock and type of surgical procedures. A standard fluid challenge with 500 ml of either solution significantly (p less than 0.01) increased pulmonary artery wedge pressure (WP), mean arterial pressure (MAP) and left ventricular stroke work index (LVSWI) and decreased systemic vascular resistance index (SVRI). Increases in LVSWI of 43% to 68% over baseline in HES patients compared favorably to 15-22% increases in ALB patients. The cardiopulmonary variables at 12 and 24 h were comparable in both groups. Improvement in cardiac function was also reflected by better tissue perfusion as judged by reduction in arterial lactate from 2.9 to 1.5 mM/L (ALB) and 2.6 to 1.4 mM/L (HES). Increased O2 delivery and reduced O2 extraction without significant deterioration of PaO2 or alveolar-arterial O2 gradient were observed with stabilization of circulation. Clinical bleeding due to colloid resuscitation was not documented and renal function was not affected significantly by either fluid. It seems that HES may offer a cost-effective alternative to ALB for patients requiring colloid resuscitation.
Authors:
V K Puri; M Howard; B B Paidipaty; S Singh
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  11     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1983 Jul 
Date Detail:
Created Date:  1983-08-17     Completed Date:  1983-08-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  518-23     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Albumins / therapeutic use*
Blood Pressure / drug effects
Colloids
Hemodynamics / drug effects
Hetastarch / therapeutic use*
Humans
Lactates / blood
Middle Aged
Oxygen / blood
Prospective Studies
Pulmonary Wedge Pressure / drug effects
Resuscitation*
Shock / drug therapy*
Starch / analogs & derivatives*
Stroke Volume / drug effects
Tissue Distribution
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Albumins; 0/Colloids; 0/Lactates; 7782-44-7/Oxygen; 9005-25-8/Starch; 9005-27-0/Hetastarch

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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