title: Effects of hydroxyethyl starch on cardiac output in hypotensive neonates: a comparison with isotonic saline and 5% albumin.
abstract: OBJECTIVE
  To evaluate the effects of hydroxyethyl starch (6% HES 200/0.5) on cardiac output in hypotensive neonates with low cardiac output and absence of myocardial dysfunction.
  
  
  METHODS
  In a prospective randomized blinded trial, 21 hypotensive neonates (mean gestational age of 29+/-3 wk) were randomly allocated to receive infusions of either 5% albumin (albumin group), isotonic saline (saline group) or hydroxyethyl starch (HES group). Infants had to show low cardiac output and an absence of myocardial dysfunction for inclusion in the study. Cardiac output was assessed by Doppler-derived mean aortic flow velocity.
  
  
  RESULTS
  Ten minutes after infusion, 67% of all infants had more than a 10% increase in cardiac output. Increases in mean aortic flow velocity (m/s; median and range) were 0.05 (-0.02, +0.07), 0.03 (-0.03, +0.12) and 0.03 (-0.04, +0.11) for the albumin, saline and HES groups, respectively (p = 0.79). The percentage of blood pressure normalization (95% confidence interval) was 86% (60-100) in the albumin group, 57% (20-94) in the saline group and 71% (37-100) in the HES group (p = 0.50).
  
  
  CONCLUSIONS
  This study did not provide evidence that hydroxyethyl starch is more efficient than isotonic saline or albumin.
authors.affiliation: Paediatric and Neonatal Intensive Care Unit, University Hospital of Nantes, France. jeanmichel.liet@chu-nantes.fr
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Liet
authors.forename: Alice
authors.initials: A
authors.lastname: Kuster
authors.forename: Sophie
authors.initials: S
authors.lastname: Denizot
authors.forename: Gaelle
authors.initials: G
authors.lastname: Caillaux-Varin
authors.forename: Christele
authors.initials: C
authors.lastname: Gras-Leguen
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
mesh_terms: D000418:Albumins / Q000494:pharmacology; D002302:Cardiac Output / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007022:Hypotension / Q000503:physiopathology*; D007231:Infant, Newborn; D007552:Isotonic Solutions; D008297:Male; D010952:Plasma Substitutes / Q000494:pharmacology*; D012121:Respiration, Artificial; D012965:Sodium Chloride / Q000494:pharmacology
chemical_list: D000418:Albumins; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D012965:Sodium Chloride