Haemodilution induced by hydroxyethyl starches 130/0.4 is similar in septic and non-septic patients.
BACKGROUND
Fluid therapy induces haemodilution related to plasma volume expansion. The aim of our study was to compare haemodilution after a single hydroxyethyl starches (HES) 130/0.4 infusion in two groups of patients, one with and one without sepsis. We hypothesized that a single HES challenge would induce similar sustained haemodilution in both groups.


METHODS
In this prospective preliminary study, patients predicted to require a single further volume-expander infusion were included immediately before receiving 500 ml of 6% HES 130/0.4 over a 15-min period. No additional fluid was administered over the next 8 h. Haematocrit, and serum albumin and protein were determined immediately before HES infusion then after 1, 2, 3, 4, and 8 h.


RESULTS
Twelve patients were included in each group. In both groups, all three haemodilution markers had significantly lower values after 1 h than at baseline. None of the values after 1 and 3 h differed significantly between the two groups. Neither did any of the other study variables show significant differences between the groups with and without sepsis.


CONCLUSIONS
We found that a starch-based compound was as effective in inducing haemodilution in patients with sepsis as in controls without sepsis, suggesting that HES may remain within the intravascular space even in patients with sepsis. Haemodilution parameters such as haematocrit, serum albumin and serum protein are useful for assessing the duration of plasma volume expansion induced by fluid therapy in critically ill patients.
AP-HP, Saint-Antoine Teaching Hospital, Medical Intensive Care Unit, Paris, F-75012 France. pascal.meyer@ch-sud-francilien.fr
P
P
Meyer
P
P
Pernet
G
G
Hejblum
J L
JL
Baudel
E
E
Maury
G
G
Offenstadt
B
B
Guidet
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D001798:Blood Proteins / Q000187:drug effects; D001809:Blood Viscosity / Q000187:drug effects; D016638:Critical Illness; D006339:Heart Rate / Q000187:drug effects; D006400:Hematocrit; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D020896:Hypovolemia / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D010952:Plasma Substitutes / Q000627:therapeutic use*; D011446:Prospective Studies; D018805:Sepsis / Q000150:complications*; D012709:Serum Albumin / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
D001798:Blood Proteins; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012709:Serum Albumin