Hemodynamic effects of 6% and 10% hydroxyethyl starch solutions versus 4% albumin solution in septic patients.
OBJECTIVE
To compare the hemodynamic effects of two different concentrations of pentastarch hydroxyethyl starch (HES; 200/0.5) solutions with a 4% human albumin solution for fluid resuscitation.


METHODS
Open-label, randomized, controlled study.


METHODS
Medical-surgical intensive care unit.


METHODS
34 consecutive, hemodynamically stable, adult patients with sepsis and suspected hypovolemia.


METHODS
Patients received a 400 mL infusion of either 10% HES (n = 11), 6% HES (n = 10), or 4% albumin (n = 13) over 40 minutes.


METHODS
Hemodynamic and blood data were collected 40, 70, 100, and 160 minutes after the start of the fluid challenge.


RESULTS
Cardiac index, stroke volume index, and left ventricular stroke work index increased more in the 10% HES group than the 6% HES or albumin groups (P < 0.05). Oxygen delivery increased only in the 10% HES group. A decrease in hemoglobin concentration occurred in all three groups but was greatest in the 10% HES group.


CONCLUSIONS
HES is as effective as albumin for volume resuscitation in septic patients.
Friedman
Gilberto
G
Department of Intensive Care, Erasme Hospital and Université libra de Bruxelles, Brussels, Belgium.
Jankowski
Stanislaw
S
Shahla
Mohammad
M
Gomez
Jussara
J
Vincent
Jean-Louis
JL
D000368:Aged; D004305:Dose-Response Relationship, Drug; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D010952:Plasma Substitutes / Q000008:administration & dosage* / Q000009:adverse effects; D018805:Sepsis / Q000503:physiopathology*; D012709:Serum Albumin / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D006454:Hemoglobins; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012709:Serum Albumin