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Titolo:
Cost analysis of different volume replacement strategies in anesthesia
Autore:
Boldt, J; Suttner, S; Kumle, B; Huttner, I;
Indirizzi:
Klinikum Stadt Ludwigshafen, Abt Anasthesiol & Operat Intens Med, D-67063 Ludwigshafen, Germany Klinikum Stadt Ludwigshafen Ludwigshafen Germany D-67063 shafen, Germany
Titolo Testata:
INFUSIONSTHERAPIE UND TRANSFUSIONSMEDIZIN
fascicolo: 1, volume: 27, anno: 2000,
pagine: 38 - 43
SICI:
1019-8466(200001)27:1<38:CAODVR>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
FLUID RESUSCITATION; PLASMA; HEMOSTASIS; THERAPY;
Keywords:
abdominal surgery; cost analysis; volume replacement; hydroxyethyl starch; gelatin;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Boldt, J Klinikum Stadt Ludwigshafen, Abt Anasthesiol & Intens Med, Bremserstr 79, D-67063 Ludwigshafen, Germany Klinikum Stadt Ludwigshafen Bremserstr 79 Ludwigshafen Germany D-67063
Citazione:
J. Boldt et al., "Cost analysis of different volume replacement strategies in anesthesia", INFUSIONSTH, 27(1), 2000, pp. 38-43

Abstract

Objective: Varying regimens of volume replacement are available. In today's climate of cost consciousness and cost containment it appears to be of interest to assess effective costs associated with the different fluid therapies. Design: Prospective, randomized study. Setting: Single-institutional, clinical investigation in an urban, university-affiliated hospital. Patients and Methods: 150 patients undergoing major abdominal surgery were dividedinto three groups. Perioperatively and until the first postoperative day, patient group 1 (n = 50) received 6% low-molecular weight hydroxyethyl starch (HES) (mean molecular weight (MW) 70 kDa, degree of substitution (DS) 0.5; HES 70/0.5), patient group 2 (n = 50) 6% medium-molecular weight HES (MW200 kDa, DS 0.5; HES 200/0.5), and patient group 3 (n = 50) 3% modified fluid gelatin (MW 35 kDa) to keep mean arterial blood pressure (MAP) >70 mm Hg and central venous pressure (CVP) between 10 and 14 mm Hg. Results: The patients did not differ with regard to biometrics, type of surgery, and postoperative care. Hemodynamics (MAP, CVP), degree of hemodilution (hemoglobin), kidney (creatinine plasma level), liver (cholinesterase), and pulmonary function (paO(2)/FlO(2)) were without significant differences within the study. No differences were seen concerning blood loss, use of packed red blood cells (PRBC) and fresh frozen plasma (FFP). Significantly more gelatin (2,590 +/- 500 mi) than HES 70/0.5 (2,130 +/- 460 mi) and HES 200/0.5 (1,680 /- 430 mi) was given during the study period. Entire costs for volume replacement (in EUR and in USD) were significantly highest in the HES 70/0.5 group (118.25 EUR/patient, 134.45 USD/patient), whereas costs in the HES 200/0.5 (99.66 EUR/patient, 113.35 USD/patient) and the gelatin group (98.57 EUR/patient, 112.06 USD/patient) did not differ. Conclusions: Maintaining quality of patients' care and simultaneously lowering costs represents a challenge. The type of fluid used for volume replacement continues to be debated. From the economic point of view the use of gelatin offers no advantage compared to the use of HES 200/0.5. Only using HES 70/0.5 for volume therapy may result in some increases in costs.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 12/07/20 alle ore 02:56:17