title: Effects of an intraoperative infusion of 4% succinylated gelatine (Gelofusine(R)) and 6% hydroxyethyl starch (Voluven(R)) on blood volume.
abstract: BACKGROUND
  This study aims to study changes in blood volume after 1 litre infusions of Gelofusine(®) [4% succinylated gelatine in 0.7% saline, weight-average molecular weight (MWw) 30 kDa] and Voluven(®) (6% hydroxyethyl starch in 0.9% saline, MWw 130 kDa) in the presence of increased capillary permeability.
  
  
  METHODS
  In this randomized double-blind study, adults undergoing laparoscopic cholecystectomy received 1 litre of Gelofusine(®) (n=12) or Voluven(®) (n=13) over 1 h at the induction of anaesthesia. No other fluids were given. Haematocrit, serum electrolytes, and osmolality were measured before infusion and hourly thereafter for 4 h. Changes in blood volume were calculated from changes in haematocrit. The urinary albumin:creatinine ratio (ACR) was measured before and after operation.
  
  
  RESULTS
  Baseline parameters before the two infusions were similar (P>0.050). The urinary ACR increased significantly after operation after Gelofusine(®) (P=0.011) and Voluven(®) (P=0.002), indicating increased capillary permeability. Voluven(®) produced a greater increase in serum chloride concentration (P=0.028) and a larger decrease in strong ion difference (P=0.009) than Gelofusine(®). There were no significant differences in changes in haematocrit (P=0.523) and blood volume (P=0.404) over the study period when the two infusions were compared, nor were there any differences in serum sodium, potassium, bicarbonate, and albumin concentrations (P>0.050). Urine output, sodium concentration, and osmolality were similar after the two infusions (P>0.050).
  
  
  CONCLUSIONS
  The blood volume-expanding effects of the two colloids were not significantly different, despite the increase in postoperative urinary ACR and the 100 kDa difference in MWw.
authors.affiliation: Division of Gastrointestinal Surgery, E Floor, West Block, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit,  Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH,  UK.
authors.forename: S
authors.initials: S
authors.lastname: Awad
authors.forename: S
authors.initials: S
authors.lastname: Dharmavaram
authors.forename: C S
authors.initials: CS
authors.lastname: Wearn
authors.forename: M G
authors.initials: MG
authors.lastname: Dube
authors.forename: D N
authors.initials: DN
authors.lastname: Lobo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001810:Blood Volume / Q000187:drug effects* / Q000502:physiology; D002199:Capillary Permeability / Q000502:physiology; D017081:Cholecystectomy, Laparoscopic; D004311:Double-Blind Method; D004573:Electrolytes / Q000097:blood; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000494:pharmacology*; D007262:Infusions, Intravenous; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000494:pharmacology*; D011097:Polygeline / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D004573:Electrolytes; D006454:Hemoglobins; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D011097:Polygeline