Hypertonic hydroxyethyl starch solution for hypovolaemia correction following heart surgery.
BACKGROUND
The aim of the study was to evaluate the effect of hypertonic NaCl hydroxyethyl starch solution on haemodynamics and cardiovascular parameters in the early postoperative period in patients for correction of hypovolaemia after heart surgery.


METHODS
Eighty patients undergoing myocardial revascularisation at the Clinic of Cardiac Surgery of the Heart Centre (Kaunas University of Medicine) were randomly divided into two groups. The HyperHaes group (n = 40) received 250ml 7.2% NaCl/6% HES solution and the control Ringer's acetate group (n = 40) received placebo (500 ml Ringer's acetate solution) for volume correction after the surgery.


RESULTS
After infusion of HyperHaes solution, cardiac index increased from 2.69 (0.7) to 3.52 (0.8) l/min/m2, systemic vascular resistance index, pulmonary vascular resistance index and the gradient between central and peripheral temperature decreased, and oxygen transport parameters improved. Ringer's group patients needed more intensive infusion therapy (4050.0 (1102.2) ml in the Ringer's group, 3513.7(762.5) ml in the HyperHaes group). During the first 24 hours postoperatively, diuresis was significantly higher in the HyperHaes group (3640.0 (1122.9) ml and 2736.0 (900.7) ml), total fluid balance was lower in HyperHaes group (1405.6 (1519.0) ml and 2718.3 (1508.0)ml, respectively). After the infusion of HyperHaes solution, no adverse events were noted.


CONCLUSIONS
HyperHaes solution had a positive effect on haemodynamic parameters and microcirculation. Oxygen transport was more effective after HyperHaes solution infusion. Higher diuresis, lower need for the infusion therapy for the first 24 hours and lower total fluid balance were determined in the HyperHaes group. No adverse effects were observed after HyperHaes solution infusion.
Sirvinskas
Edmundas
E
Institute for Biomedical Research of Kaunas University of Medicine, Kaunas, Lithuania. sirdiskr@kmu.lt
Sneider
Edvin
E
Svagzdiene
Milda
M
Vaskelyte
Jolanta
J
Raliene
Laima
L
Marchertiene
Irena
I
Adukauskiene
Dalia
D
D000368:Aged; D006348:Cardiac Surgical Procedures; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D006982:Hypertonic Solutions / Q000008:administration & dosage; D020896:Hypovolemia / Q000628:therapy*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000628:therapy*; D011446:Prospective Studies; D014655:Vascular Resistance / Q000187:drug effects; D014882:Water-Electrolyte Balance / Q000187:drug effects
D006895:Hydroxyethyl Starch Derivatives; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; C028570:Ringer's acetate; D010100:Oxygen