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Hypertonic hydroxyethyl starch solution for hypovolaemia correction following heart surgery

Institute for Biomedical Research of Kaunas University of Medicine, Kaunas, Lithuania, sirdiskr{at}kmu.lt

Edvin Sneider

Institute for Biomedical Research of Kaunas University of Medicine, Kaunas, Lithuania

Milda Svagzdiene

Institute for Biomedical Research of Kaunas University of Medicine, Kaunas, Lithuania

Jolanta Vaskelyte

Institute of Cardiology of Kaunas University of Medicine, Kaunas, Lithuania

Laima Raliene

Institute for Biomedical Research of Kaunas University of Medicine, Kaunas, Lithuania

Irena Marchertiene

Clinic of Anesthesiology of Kaunas University Hospital, Kaunas, Lithuania

Dalia Adukauskiene

Clinic of Intensive Care of Kaunas University Hospital, Kaunas, Lithuania

Background. The aim of the study was to evaluate the effect of hypertonic NaCl hydroxyethyl starch solution on haemodynamics and cardiovascular parameters in the early postoperative period in patients for correction of hypovolaemia after heart surgery. Methods. Eighty patients undergoing myocardial revascularisation at the Clinic of Cardiac Surgery of the Heart Centre (Kaunas University of Medicine) were randomly divided into two groups. The HyperHaes^® group (n = 40) received 250 ml 7.2% NaCl/6% HES solution and the control Ringer's acetate group (n = 40) received placebo (500ml Ringer's acetate solution) for volume correction after the surgery. Results. After infusion of HyperHaes^® solution, cardiac index increased from 2.69 (0.7) to 3.52 (0.8)l/min/m², systemic vascular resistance index, pulmonary vascular resistance index and the gradient between central and peripheral temperature decreased, and oxygen transport parameters improved. Ringer's group patients needed more intensive infusion therapy (4050.0 (1102.2) ml in the Ringer's group, 3513.7(762.5) ml in the HyperHaes^® group). During the first 24 hours postoperatively, diuresis was significantly higher in the HyperHaes^® group (3640.0 (1122.9) ml and 2736.0 (900.7) ml), total fluid balance was lower in HyperHaes^® group (1405.6 (1519.0) ml and 2718.3 (1508.0) ml, respectively). After the infusion of HyperHaes ^® solution, no adverse events were noted. Conclusions. HyperHaes ^® solution had a positive effect on haemodynamic parameters and microcirculation. Oxygen transport was more effective after HyperHaes^® solution infusion. Higher diuresis, lower need for the infusion therapy for the first 24 hours and lower total fluid balance were determined in the HyperHaes^® group. No adverse effects were observed after HyperHaes^® solution infusion. Perfusion (2007) 22, 121—127.

Key Words: hypertonic saline • hydroxyethyl starch • coronary artery bypass graft surgery • small-volume resuscitation • hypertonic-colloid solutions.

Perfusion, Vol. 22, No. 2, 121-127 (2007)
DOI: 10.1177/0267659107078484


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