Comparison of the hemodynamic and oxygen transport responses to modified fluid gelatin and hetastarch in critically ill patients: a prospective, randomized trial.
OBJECTIVE
To compare the hemodynamic and oxygen transport responses to a rapid (< 10-min) infusion of 500 mL of modified fluid gelatin (group A) or hydroxyethyl starch (group B) in patients suffering from acute hypovolemia.


METHODS
Prospective, randomized, noncrossover study.


METHODS
University hospital, general intensive care unit.


METHODS
Twenty-eight patients with hypovolemia mechanically ventilated for concurrent acute respiratory failure.


METHODS
Patients were mechanically ventilated. Pulmonary and femoral artery catheters were used for hemodynamic monitoring.


RESULTS
Hemodynamic and oxygen transport variables were determined at baseline, 15 mins, and 30 mins after the infusion of each fluid. In both groups pulmonary artery occlusion pressure, stroke volume, and cardiac index significantly increased. In neither group did heart rate decrease. Oxygen delivery increased significantly in group A patients but not in group B patients. This result was due to greater hemodilution in group B patients.


CONCLUSIONS
There are no significant differences in the hemodynamic responses to hydroxyethyl starch or modified fluid gelatin. The hemodynamic and oxygen transport effects of artificial colloid solutions may not be entirely predictable and should be monitored in critically ill patients.
Beards
S C
SC
Intensive Care Unit, University Hospital South Manchester, UK.
Watt
T
T
Edwards
J D
JD
Nightingale
P
P
Farragher
E B
EB
D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005780:Gelatin / Q000008:administration & dosage*; D006439:Hemodynamics; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies; D012769:Shock / Q000628:therapy*
D006895:Hydroxyethyl Starch Derivatives; D005780:Gelatin