Effects of polygeline and hydroxyethyl starch solutions on liver functions assessed with LIMON in hypovolemic patients.
BACKGROUND
Hypovolemia is a common clinical entity in critical patients, and adequate volume replacement therapy seems to be essential for maintaining tissue perfusion. However, it is still uncertain which solution is most appropriate for fluid resuscitation.


OBJECTIVE
The aim of this study was to investigate the effects of fluid resuscitation with 3.5% polygeline versus 6% hydroxyethyl starch solutions on hemodynamic functions and liver functions assessed with a noninvasive liver function monitoring system (LIMON) in hypovolemic patients.


METHODS
This study is a prospective randomized clinical trial.


RESULTS
Thirty hypovolemic patients (intrathoracic blood volume index, <850 mL/m(2)) were randomized into hydroxyethyl starch (mean molecular weight, 130,000 Da) and polygeline (mean molecular weight, 30,000 Da) groups (15 patients each). Indocyanine green plasma disappearance elimination (ICG-PDR) were conducted concurrently using LIMON. A dose of 0.3 mg/kg ICG was given through a cubital fossa vein as a bolus. For fluid resuscitation, 500 mL of colloid was given to the patients. Repeated hemodynamic and ICG-PDR measurements were done at baseline, after infusion, and then at 30 minutes after infusion.


RESULTS
Intrathoracic blood volume index and systolic, diastolic, and mean blood pressures increased significantly after infusion and remained elevated for 30 minutes after infusion, but there was no significant difference between the 2 groups. Indocyanine green plasma disappearance elimination values were similar in both groups with no significant difference between the two.


CONCLUSIONS
Increasing intrathoracic blood volume index and hemodynamic variables by fluid loading is not associated with a significant change in ICG-PDR.
Inal
Mehmet Turan
MT
Trakya University Faculty of Medicine, Department of Anesthesiology and Reanimation, Edirne 22030, Turkey.
Memiş
Dilek
D
Karamanlioglu
Beyhan
B
Sut
Necdet
N
D004396:Coloring Agents; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology* / Q000627:therapeutic use; D020896:Hypovolemia / Q000628:therapy*; D007208:Indocyanine Green; D008102:Liver Circulation / Q000187:drug effects*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000494:pharmacology* / Q000627:therapeutic use; D011097:Polygeline / Q000494:pharmacology* / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
D004396:Coloring Agents; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D011097:Polygeline; D007208:Indocyanine Green