Lactated Ringer's solution versus hydroxyethyl starch for volume replacement in autologous blood donors with cardiovascular disease: a controlled, randomized trial.
OBJECTIVE
The study was designed to evaluate whether volume replacement following blood donation can prevent arterial hypotension in autologous blood donors with cardiovascular disease.


METHODS
One hundred nineteen autologous blood donors with known cardiovascular disease were randomly allocated to receive, following withdrawal of 500 ml of blood, either no infusion (control group) or a 25 ml/min intravenous infusion of either 1,500 ml of lactated Ringer's solution (LRS) or 500 ml of 6% hydroxyethyl starch (HES). Starting before phlebotomy, arterial blood pressure was measured oscillometrically every 5 min until 90 min after donation.


RESULTS
Group means showed little difference between the groups in blood pressure throughout the monitoring period. The proportion of patients who at least once had a > or = 20% decrease from baseline in systolic blood pressure was 3-5 times greater in the control group than in the LRS and the HES group (50 vs. 10 and 15%, respectively; p < 0.001 on chi 2 analysis for a 2 x 3 table). Systolic hypertensive episodes (> or = 20% increase over baseline) were observed more frequently in the LRS group than in the control and the HES group (41 vs. 10 and 18%, respectively; p = 0.003).


CONCLUSIONS
Both LRS and HES, administered at a volume ratio to blood loss of 3:1 and 1:1, respectively, significantly reduced the incidence of systolic hypotensive episodes in autologous blood donors with cardiovascular disease. LRS at a 3:1 volume ratio to blood loss was associated with a high rate of systolic hypertension.
Kasper
S M
SM
Department of Anesthesiology, University of Cologne, Germany.
Dahlmann
H
H
Mellinghoff
H
H
Ellering
J
J
Baumann
M
M
Buzello
W
W
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D001802:Blood Substitutes; D001804:Blood Transfusion, Autologous; D001810:Blood Volume / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006973:Hypertension / Q000139:chemically induced; D007022:Hypotension / Q000517:prevention & control; D007552:Isotonic Solutions / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077325:Ringer's Lactate; D014555:Urination Disorders / Q000139:chemically induced
D001802:Blood Substitutes; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate