[Effect of volume replacement with hydroxyethyl starch solution for blood loss on splanchnic oxygenation in patients undergoing cytoreductive surgery for ovarian carcinoma].
OBJECTIVE
To investigate the effect of medium molecular weight hydroxyethyl starch solution (HES) administered as replacement for estimated blood losses (EBL) during cytoreductive surgery for ovarian carcinoma on splanchnic oxygenation.


METHODS
Cytoreductive surgery was operated upon forty-two patients with ovarian carcinoma. As soon as the EBL was higher than 10% but less than 20% of the estimated blood volume, the patients were randomly assigned to receive a volume of lactated Ringer's solution (LRS) equal to three times the EBL (LRS group, n = 22) or a volume of 6% HES equal to the EBL (HES group, n = 20). Tissue oxygenation was assessed indirectly by measuring the tonometric parameters of stomach, including difference between gastric intramucosal PsCO(2) and arterial PaCO(2) (Ps-aCO(2) gap), gastric intramucosal pH (pHi) and arterial lactate acid concentration 30 min after induction of anesthesia (baseline value), 1 h and 2 h after skin incision, and at the end of surgery.


RESULTS
At the end of surgery, the Ps-aCO(2) gap was 8.7 mm Hg +/- 1.6 mm Hg in the HES group, significantly lower than that in the LRS group (18.74 mm Hg +/- 4.4 mm Hg, P < 0.01), while the pHi in the HES group was 7.30 +/- 0.05, significantly higher than that in the LRS group (7.21 +/- 0.07, P < 0.01). There was no significant difference in arterial lactate acid concentration between the two groups.


CONCLUSIONS
In patients undergoing major surgery, volume resuscitation with medium molecular weight HES improves the splanchnic blood flow and tissue oxygenation.
Guo
Xiang-yang
XY
Department of Anesthesia, Peking Union Medical College Hospital, Beijing 100730, China.
Xu
Zhong-huang
ZH
Ren
Hong-zhi
HZ
Luo
Ai-lun
AL
Huang
Yu-guang
YG
Ye
Tie-hu
TH
D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery*; D010100:Oxygen / Q000378:metabolism*; D010952:Plasma Substitutes / Q000627:therapeutic use; D013152:Splanchnic Circulation
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D010100:Oxygen