Document Detail


Small volume resuscitation for acute intraoperative haemorrhage: comparison of 7.5% saline and 6% hydroxyethyl starch.
MedLine Citation:
PMID:  19517670     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The immediate effect of acute haemorrhage is a significant reduction in tissue blood flow, frequently resulting in haemorrhagic shock. The main aim of resuscitation after bleeding is the immediate restoration of intravascular volume. Intravenous administration of volume expanders should be commenced immediately, regardless of whether they are colloids or electrolytes. The purpose of the study was to analyze haemodynamic changes during intraoperative acute bleeding and to compare the effects of intravenous infusion with 7.5% saline solution to 6% starch solution on the volume resuscitation process. METHODS: Sixty adult patients, of both sexes, in whom massive loss of blood followed by rapid cardiovascular collapse occurred during elective surgery, were enrolled in the study. In addition to standard fluid transfusion, all patients received either 4 mL kg(-1) of 7.5% NaCl solution or an equal volume of 6% of hydroxyethyl starch. Heart rate (HR) and mean arterial pressure (MAP) were noted. Cardiac output (CO) and systemic vascular resistance (SVR) were measured using a descending aortic blood flow ultrasound monitor. RESULTS: Massive intraoperative haemorrhage resulted in a rapid decrease in CO and SV with a simultaneous increase in HR and SVR in all patients. Injection of hypertonic salt or 6% HAES over 5 min increased the CO and SV. HR and SVR returned quickly to pre-existing levels and remained so until the end of the procedures. CONCLUSION: Small volume resuscitation with 7.5% saline or starch can be regarded as an efficient and effective method for restoring intravascular volume.
Authors:
Jerzy Ratajczak; Andrzej B Szczepanik; Alfred J Meissner; Alina Ostas; Adam Wiszniewski; Radosław Bilski
Publication Detail:
Type:  Comparative Study; English Abstract; Journal Article    
Journal Detail:
Title:  Anestezjologia intensywna terapia     Volume:  41     ISSN:  0209-1712     ISO Abbreviation:  Anestezjol Intens Ter     Publication Date:    2009 Jan-Mar
Date Detail:
Created Date:  2009-06-12     Completed Date:  2009-06-25     Revised Date:  2009-08-04    
Medline Journal Info:
Nlm Unique ID:  9424972     Medline TA:  Anestezjol Intens Ter     Country:  Poland    
Other Details:
Languages:  pol     Pagination:  6-10     Citation Subset:  IM    
Affiliation:
Klinika Chirurgii Ogólnej i Hematologicznej Instytutu Hematologii i Transfuzjologii w Warszawie. jratajczak@ihit.waw.pl
Vernacular Title:
Porównanie wpływu przetoczeń małych objetości 7,5% roztworu NaCL lub 6% roztworu hydroksy-etylowanej skrobi na zaburzenia hemodynamiczne, morfologiczne i elektrolitowe u chorych ze śródoperacyjna, ostra utrata krwi krazacej.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Blood Loss, Surgical*
Female
Hemodynamics*
Hetastarch / administration & dosage*
Humans
Infusions, Intravenous
Male
Middle Aged
Plasma Substitutes / administration & dosage*
Resuscitation / methods*
Shock, Hemorrhagic / physiopathology,  therapy*,  ultrasonography
Sodium Chloride / administration & dosage*
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Plasma Substitutes; 7647-14-5/Sodium Chloride; 9005-27-0/Hetastarch

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