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Hemodynamic effects of 6% and 10% hydroxyethyl starch solutions versus 4% albumin solution in septic patients

par Friedman, Gilberto;Jankowski, Stanislaw;Shahla, Mohammad;Gomez, Jussara;Vincent, Jean Louis
Référence Journal of clinical anesthesia, 20, 7, page (528-533)
Publication Publié, 2008-11

Article révisé par les pairs

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Résumé :

Study Objective: To compare the hemodynamic effects of two different concentrations of pentastarch hydroxyethyl starch (HES; 200/0.5) solutions with a 4% human albumin solution for fluid resuscitation. Design: Open-label, randomized, controlled study. Setting: Medical-surgical intensive care unit. Patients: 34 consecutive, hemodynamically stable, adult patients with sepsis and suspected hypovolemia. Interventions: Patients received a 400 mL infusion of either 10% HES (n = 11), 6% HES (n = 10), or 4% albumin (n = 13) over 40 minutes. Measurements: Hemodynamic and blood data were collected 40, 70, 100, and 160 minutes after the start of the fluid challenge. Main Results: Cardiac index, stroke volume index, and left ventricular stroke work index increased more in the 10% HES group than the 6% HES or albumin groups (P < 0.05). Oxygen delivery increased only in the 10% HES group. A decrease in hemoglobin concentration occurred in all three groups but was greatest in the 10% HES group. Conclusions: HES is as effective as albumin for volume resuscitation in septic patients. © 2008 Elsevier Inc. All rights reserved.