A total balanced volume replacement strategy using a new balanced hydoxyethyl starch preparation (6% HES 130/0.42) in patients undergoing major abdominal surgery
BACKGROUND AND OBJECTIVE:The kind of fluid for correcting hypovolaemia is still a focus of debate. In a prospective, randomized, controlled and double-blind study in patients undergoing major abdominal surgery, a total balanced volume replacement strategy including a new balanced hydroxyethyl starch...
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| Veröffentlicht in: | European journal of anaesthesiology 2007-03, Vol.24 (3), p.267-275 |
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| container_title | European journal of anaesthesiology |
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| creator | Boldt, J. Schöllhorn, T. Münchbach, J. Pabsdorf, M. |
| description | BACKGROUND AND OBJECTIVE:The kind of fluid for correcting hypovolaemia is still a focus of debate. In a prospective, randomized, controlled and double-blind study in patients undergoing major abdominal surgery, a total balanced volume replacement strategy including a new balanced hydroxyethyl starch (HES) solution was compared with a conventional, non-balanced fluid regimen.
METHODS:In Group A (n = 15), a new balanced 6% HES 130/0.42 was given along with a balanced crystalloid solution; in Group B (n = 15), an unbalanced conventional HES 130/0.42 plus an unbalanced crystalloid (saline solution) were administered. Volume was given when mean arterial pressure (MAP) was |
| doi_str_mv | 10.1017/S0265021506001682 |
| format | Article |
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METHODS:In Group A (n = 15), a new balanced 6% HES 130/0.42 was given along with a balanced crystalloid solution; in Group B (n = 15), an unbalanced conventional HES 130/0.42 plus an unbalanced crystalloid (saline solution) were administered. Volume was given when mean arterial pressure (MAP) was <65 mmHg and central venous pressure (CVP) minus positive end-expiratoric pressure (PEEP) level was <10 mmHg. Haemodynamics, acid–base status, coagulation (thrombelastography (TEG)) and kidney function (including kidney-specific proteins, N-acetyl-beta-d-glucosaminidase (beta-NAG) and alpha-1-microglobulin) were measured after induction of anaesthesia, at the end of surgery, 5 and 24 h after surgery.
RESULTS:Group A received 3533 ± 1302 mL of HES and 5333 ± 1063 mL of crystalloids, in Group B, 3866 ± 1674 mL of HES and 5966 ± 1202 mL of crystalloids were given. Haemodynamics, laboratory data, TEG data and kidney function were without significant differences between the groups. Cl concentration and base excess (−5 ± 2.4 mmol L vs. 0.4 ± 2.4 mmol L) were significantly higher in patients of Group B than of Group A.
CONCLUSIONS:A complete balanced volume replacement strategy including a new balanced HES preparation resulted in significantly less derangement in acid–base status compared with a non-balanced volume replacement regimen. The new HES preparation showed no negative effects on coagulation and kidney function.</description><identifier>ISSN: 0265-0215</identifier><identifier>EISSN: 1365-2346</identifier><identifier>DOI: 10.1017/S0265021506001682</identifier><identifier>PMID: 17054812</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Abdomen - surgery ; Acid-Base Equilibrium - drug effects ; Aged ; Aged, 80 and over ; Blood Pressure - drug effects ; Blood Volume ; Double-Blind Method ; Female ; Humans ; Hydroxyethyl Starch Derivatives - therapeutic use ; Hypovolemia - therapy ; Isotonic Solutions - administration & dosage ; Kidney Function Tests - methods ; Male ; Middle Aged ; Plasma Substitutes - therapeutic use ; Prospective Studies ; Sodium Chloride - administration & dosage ; Thrombelastography - methods ; Time Factors</subject><ispartof>European journal of anaesthesiology, 2007-03, Vol.24 (3), p.267-275</ispartof><rights>Copyright © European Society of Anaesthesiology 2006</rights><rights>2007 European Society of Anaesthesiology</rights><rights>2006 European Society of Anaesthesiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4580-e058c9f207ed76ad1a81c8efda08637db4e88b99a35878b9955d96b08ac121e13</citedby><cites>FETCH-LOGICAL-c4580-e058c9f207ed76ad1a81c8efda08637db4e88b99a35878b9955d96b08ac121e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17054812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boldt, J.</creatorcontrib><creatorcontrib>Schöllhorn, T.</creatorcontrib><creatorcontrib>Münchbach, J.</creatorcontrib><creatorcontrib>Pabsdorf, M.</creatorcontrib><title>A total balanced volume replacement strategy using a new balanced hydoxyethyl starch preparation (6% HES 130/0.42) in patients undergoing major abdominal surgery</title><title>European journal of anaesthesiology</title><addtitle>Eur J Anaesthesiol</addtitle><description>BACKGROUND AND OBJECTIVE:The kind of fluid for correcting hypovolaemia is still a focus of debate. In a prospective, randomized, controlled and double-blind study in patients undergoing major abdominal surgery, a total balanced volume replacement strategy including a new balanced hydroxyethyl starch (HES) solution was compared with a conventional, non-balanced fluid regimen.
METHODS:In Group A (n = 15), a new balanced 6% HES 130/0.42 was given along with a balanced crystalloid solution; in Group B (n = 15), an unbalanced conventional HES 130/0.42 plus an unbalanced crystalloid (saline solution) were administered. Volume was given when mean arterial pressure (MAP) was <65 mmHg and central venous pressure (CVP) minus positive end-expiratoric pressure (PEEP) level was <10 mmHg. Haemodynamics, acid–base status, coagulation (thrombelastography (TEG)) and kidney function (including kidney-specific proteins, N-acetyl-beta-d-glucosaminidase (beta-NAG) and alpha-1-microglobulin) were measured after induction of anaesthesia, at the end of surgery, 5 and 24 h after surgery.
RESULTS:Group A received 3533 ± 1302 mL of HES and 5333 ± 1063 mL of crystalloids, in Group B, 3866 ± 1674 mL of HES and 5966 ± 1202 mL of crystalloids were given. Haemodynamics, laboratory data, TEG data and kidney function were without significant differences between the groups. Cl concentration and base excess (−5 ± 2.4 mmol L vs. 0.4 ± 2.4 mmol L) were significantly higher in patients of Group B than of Group A.
CONCLUSIONS:A complete balanced volume replacement strategy including a new balanced HES preparation resulted in significantly less derangement in acid–base status compared with a non-balanced volume replacement regimen. The new HES preparation showed no negative effects on coagulation and kidney function.</description><subject>Abdomen - surgery</subject><subject>Acid-Base Equilibrium - drug effects</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Pressure - drug effects</subject><subject>Blood Volume</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Humans</subject><subject>Hydroxyethyl Starch Derivatives - therapeutic use</subject><subject>Hypovolemia - therapy</subject><subject>Isotonic Solutions - administration & dosage</subject><subject>Kidney Function Tests - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Plasma Substitutes - therapeutic use</subject><subject>Prospective Studies</subject><subject>Sodium Chloride - administration & dosage</subject><subject>Thrombelastography - methods</subject><subject>Time Factors</subject><issn>0265-0215</issn><issn>1365-2346</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kVGL1DAUhYso7uzqD_BFgqDoQ3dvkiZNH5dl1xUWfFh9Lmlzp-2YNjVpd-zP8Z-aMgMDig8hudzvHE44SfKGwiUFml89ApMCGBUgAahU7FmyoVyKlPFMPk826zpd92fJeQg7ABBR9zI5ozmITFG2SX5fk8lN2pJKWz3UaMiTs3OPxONodY09DhMJk9cTNguZQzc0RJMB9ydBuxj3a8GpXWwkta9bMka1jprODeSjfE_ubx8J5XAFlxn7RLqBjHEXnQOZB4O-cattr3fOE10Z13dDTBRm36BfXiUvttoGfH28L5Lvd7ffbu7Th6-fv9xcP6R1JhSkCELVxZZBjiaX2lCtaK1wazQoyXNTZahUVRSaC5WvDyFMIStQuqaMIuUXyYeD7-jdzxnDVPZdqNHGX6KbQylVUeQS8gi--wvcudnHxKFkVEqgIHiE6AGqvQvB47Ycfddrv5QUyrW88p_youbt0XiuejQnxbGtCGQHYO_shD78sPMefdmitlNbxnqBy4ynDCAHHqc0HgpRxo9ZdF_5zjR4Svz_NH8A4OSzXQ</recordid><startdate>200703</startdate><enddate>200703</enddate><creator>Boldt, J.</creator><creator>Schöllhorn, T.</creator><creator>Münchbach, J.</creator><creator>Pabsdorf, M.</creator><general>Cambridge University Press</general><general>European Society of Anaesthesiology</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200703</creationdate><title>A total balanced volume replacement strategy using a new balanced hydoxyethyl starch preparation (6% HES 130/0.42) in patients undergoing major abdominal surgery</title><author>Boldt, J. ; Schöllhorn, T. ; Münchbach, J. ; Pabsdorf, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4580-e058c9f207ed76ad1a81c8efda08637db4e88b99a35878b9955d96b08ac121e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Abdomen - surgery</topic><topic>Acid-Base Equilibrium - drug effects</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Pressure - drug effects</topic><topic>Blood Volume</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Humans</topic><topic>Hydroxyethyl Starch Derivatives - therapeutic use</topic><topic>Hypovolemia - therapy</topic><topic>Isotonic Solutions - administration & dosage</topic><topic>Kidney Function Tests - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Plasma Substitutes - therapeutic use</topic><topic>Prospective Studies</topic><topic>Sodium Chloride - administration & dosage</topic><topic>Thrombelastography - methods</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boldt, J.</creatorcontrib><creatorcontrib>Schöllhorn, T.</creatorcontrib><creatorcontrib>Münchbach, J.</creatorcontrib><creatorcontrib>Pabsdorf, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of anaesthesiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boldt, J.</au><au>Schöllhorn, T.</au><au>Münchbach, J.</au><au>Pabsdorf, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A total balanced volume replacement strategy using a new balanced hydoxyethyl starch preparation (6% HES 130/0.42) in patients undergoing major abdominal surgery</atitle><jtitle>European journal of anaesthesiology</jtitle><addtitle>Eur J Anaesthesiol</addtitle><date>2007-03</date><risdate>2007</risdate><volume>24</volume><issue>3</issue><spage>267</spage><epage>275</epage><pages>267-275</pages><issn>0265-0215</issn><eissn>1365-2346</eissn><abstract>BACKGROUND AND OBJECTIVE:The kind of fluid for correcting hypovolaemia is still a focus of debate. In a prospective, randomized, controlled and double-blind study in patients undergoing major abdominal surgery, a total balanced volume replacement strategy including a new balanced hydroxyethyl starch (HES) solution was compared with a conventional, non-balanced fluid regimen.
METHODS:In Group A (n = 15), a new balanced 6% HES 130/0.42 was given along with a balanced crystalloid solution; in Group B (n = 15), an unbalanced conventional HES 130/0.42 plus an unbalanced crystalloid (saline solution) were administered. Volume was given when mean arterial pressure (MAP) was <65 mmHg and central venous pressure (CVP) minus positive end-expiratoric pressure (PEEP) level was <10 mmHg. Haemodynamics, acid–base status, coagulation (thrombelastography (TEG)) and kidney function (including kidney-specific proteins, N-acetyl-beta-d-glucosaminidase (beta-NAG) and alpha-1-microglobulin) were measured after induction of anaesthesia, at the end of surgery, 5 and 24 h after surgery.
RESULTS:Group A received 3533 ± 1302 mL of HES and 5333 ± 1063 mL of crystalloids, in Group B, 3866 ± 1674 mL of HES and 5966 ± 1202 mL of crystalloids were given. Haemodynamics, laboratory data, TEG data and kidney function were without significant differences between the groups. Cl concentration and base excess (−5 ± 2.4 mmol L vs. 0.4 ± 2.4 mmol L) were significantly higher in patients of Group B than of Group A.
CONCLUSIONS:A complete balanced volume replacement strategy including a new balanced HES preparation resulted in significantly less derangement in acid–base status compared with a non-balanced volume replacement regimen. The new HES preparation showed no negative effects on coagulation and kidney function.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>17054812</pmid><doi>10.1017/S0265021506001682</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of anaesthesiology, 2007-03, Vol.24 (3), p.267-275 |
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| subjects | Abdomen - surgery Acid-Base Equilibrium - drug effects Aged Aged, 80 and over Blood Pressure - drug effects Blood Volume Double-Blind Method Female Humans Hydroxyethyl Starch Derivatives - therapeutic use Hypovolemia - therapy Isotonic Solutions - administration & dosage Kidney Function Tests - methods Male Middle Aged Plasma Substitutes - therapeutic use Prospective Studies Sodium Chloride - administration & dosage Thrombelastography - methods Time Factors |
| title | A total balanced volume replacement strategy using a new balanced hydoxyethyl starch preparation (6% HES 130/0.42) in patients undergoing major abdominal surgery |
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