title: Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon.
abstract: BACKGROUND
  The aim of this study was to compare the effects of goal-directed colloid fluid therapy with goal-directed crystalloid and restricted crystalloid fluid therapy on healthy and perianastomotic colon tissue in a pig model of colon anastomosis surgery.
  
  
  METHODS
  Pigs (n = 27, 9 per group) were anesthetized and mechanically ventilated. A hand-sewn colon anastomosis was performed. The animals were subsequently randomized to one of the following treatments: R-RL group, 3 ml x kg(-1) x h(-1) Ringer lactate (RL); GD-RL group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of RL; GD-C group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of hydroxyethyl starch (HES 6%, 130/0.4). A fluid bolus was administered when mixed venous oxygen saturation dropped below 60%. Intestinal tissue oxygen tension and microcirculatory blood flow were measured continuously.
  
  
  RESULTS
  After 4 h of treatment, tissue oxygen tension in healthy colon increased to 150 +/- 31% in group GD-C versus 123 +/- 40% in group GD-RL versus 94 +/- 23% in group R-RL (percent of postoperative baseline values, mean +/- SD; P < 0.01). Similarly perianastomotic tissue oxygen tension increased to 245 +/- 93% in the GD-C group versus 147 +/- 58% in the GD-RL group and 116 +/- 22% in the R-RL group (P < 0.01). Microcirculatory flow was higher in group GD-C in healthy colon.
  
  
  CONCLUSIONS
  Goal-directed colloid fluid therapy significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal-directed or restricted crystalloid fluid therapy.
authors.affiliation: Department of Anesthesiology and Pain Therapy, Inselspital-University Hospital Bern, Switzerland. study@kimberger.at
authors.forename: Oliver
authors.initials: O
authors.lastname: Kimberger
authors.forename: Michael
authors.initials: M
authors.lastname: Arnberger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Brandt
authors.forename: Jan
authors.initials: J
authors.lastname: Plock
authors.forename: Gisli H
authors.initials: GH
authors.lastname: Sigurdsson
authors.forename: Andrea
authors.initials: A
authors.lastname: Kurz
authors.forename: Luzius
authors.initials: L
authors.lastname: Hiltebrand
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D003102:Colloids / Q000008:administration & dosage*; D003106:Colon / Q000098:blood supply* / Q000187:drug effects / Q000601:surgery*; D005440:Fluid Therapy / Q000379:methods; D006040:Goals; D008833:Microcirculation / Q000187:drug effects* / Q000502:physiology; D013552:Swine
chemical_list: D003102:Colloids