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Titolo:
Hemodynamic effects of hypertonic hydroxyethyl starch 6% solution and isotonic hydroxyethyl starch 6% solution after declamping during abdominal aortic aneurysm repair
Autore:
Ragaller, M; Muller, M; Bleyl, JU; Strecker, A; Segiet, W; Ellinger, K; Albrecht, DM;
Indirizzi:
Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Anaesthesiol & IntensCare Med, D-01307 Dresden, Germany Tech Univ Dresden Dresden Germany D-01307 Med, D-01307 Dresden, Germany Univ Heidelberg, Klinikum Mannheim, Dept Anaesthesiol & Intens Care Med, Heidelberg, Germany Univ Heidelberg Heidelberg Germany Intens Care Med, Heidelberg, Germany
Titolo Testata:
SHOCK
fascicolo: 5, volume: 13, anno: 2000,
pagine: 367 - 373
SICI:
1073-2322(200005)13:5<367:HEOHHS>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
ATRIAL-NATRIURETIC-FACTOR; SMALL-VOLUME RESUSCITATION; LACTATED RINGER SOLUTION; SALINE-DEXTRAN; HEMORRHAGIC-SHOCK; HYPERONCOTIC SOLUTIONS; INTRACRANIAL-PRESSURE; MYOCARDIAL-ISCHEMIA; HYPOVOLEMIC SHOCK; 7.5-PERCENT NACL;
Keywords:
hypertonic-hydroxyethyl starch; volume loading; best wedge; aortic aneurysm surgery; aortic declamping; fluid resuscitation; high-risk patients;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
38
Recensione:
Indirizzi per estratti:
Indirizzo: Ragaller, M Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Anaesthesiol & IntensCare Med, Fetscherstrasse 74, D-01307 Dresden, Germany Tech Univ Dresden Fetscherstrasse 74 Dresden Germany D-01307
Citazione:
M. Ragaller et al., "Hemodynamic effects of hypertonic hydroxyethyl starch 6% solution and isotonic hydroxyethyl starch 6% solution after declamping during abdominal aortic aneurysm repair", SHOCK, 13(5), 2000, pp. 367-373

Abstract

Fluid resuscitation with hypertonic hydroxyethyl starch solutions (HES) iseffective in haemorrhagic shock due to the rapid mobilisation of fluids into the intravascular compartment. Declamping of the abdominal aorta with acute redistribution of blood into the vessels of the lower body half causes declamping-induced hypotension. Usually large amount of fluids or vasopressors are necessary to restore hemodynamic stability. Therefore, infusion of a hypertonic colloid solution may be an attractive option to achieve hemodynamic stability. This study was conducted to determine the amount of fluid of either hypertonic HES (HES 6%;7.2% NaCl) or isotonic HES (HES 6%;0.9% NaCl) needed to attain best wedge pressure (PCWP) cardiac index (CI) relationafter declamping. Thirty-two high-risk patients undergoing elective abdominal aneurysm resection were enrolled in a prospective, randomised, double blinded study. The individual optimised PCWP/Cl relation was determined after induction of anaesthesia. After declamping, both solutions were titrated in small boluses of 100 mL until the previously determined best wedge was reached. The amount of fluid after declamping was significantly reduced in the hypertonic HES- group 162 mL vs. 265 mL in the control group (P < 0.05). Resuscitation time was shortened, and cardiac index was slightly higher inthe treatment group. The use of hypertonic HES-solution after aortic declamping led to a significant reduction of fluids necessary to attain optimised PCWP/Cl relation. In this clinical trial with moderate blood loss in high-risk patients, hypertonic HES applied in a titrated fashion restored hemodynamic stability faster and without volume overload.

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Documento generato il 08/08/20 alle ore 20:28:30