Effects of hydroxyethyl starch on cardiac output in hypotensive neonates: a comparison with isotonic saline and 5% albumin.
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.
Liet
Jean Michel
JM
Paediatric and Neonatal Intensive Care Unit, University Hospital of Nantes, France. jeanmichel.liet@chu-nantes.fr
Kuster
Alice
A
Denizot
Sophie
S
Caillaux-Varin
Gaelle
G
Gras-Leguen
Christele
C
Rozé
Jean-Christophe
JC
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
D000418:Albumins; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D012965:Sodium Chloride