title: The effect of hydroxyethyl starch 6% 130/0.4 compared with gelatin on microvascular reactivity.
abstract: We compared the effects on microvascular reactivity of hydroxyethylstarch (Volulyte(®) ) and gelatin (Geloplasma(®) ) during acute haemodilution. The hypothesis was that Volulyte would provide better microvascular reactivity than Geloplasma. Forty patients undergoing elective cardiac surgery were randomly assigned to receive either Volulyte or Geloplasma as the exclusive priming solution of the cardiopulmonary bypass. To evaluate microvascular reactivity, postocclusive reactive hyperaemia was examined before and after cardiopulmonary bypass. Microvascular reactivity assessments included the rate of the occlusion and reperfusion slopes and reperfusion times. After cardiopulmonary bypass, increases in reperfusion time were significantly smaller in the Volulyte group (3 (-27 to 9 [-35 to 33]%) vs 29 (-17 to 76 [-34 to 137]%) in the Geloplasma group, p = 0.02 between groups). Rate of reperfusion increased in the Volulyte group (26 (-17 to 43 [-59 to 357])%), whereas it decreased in the Geloplasma group (-22 (-47 to 16 [-84 to 113])%), p = 0.02 between groups. The shorter reperfusion times and increased reperfusion rate suggest that Volulyte maintains better microvascular reactivity than Geloplasma.
authors.affiliation: Department of Anaesthesiology, Ghent University Hospital, Gent, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Moerman
authors.affiliation: Department of Anaesthesiology, Ghent University Hospital, Gent, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Van Eeckhout
authors.affiliation: Ghent University, Gent, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Vanderstraeten
authors.affiliation: Department of Cardiac Surgery, Ghent University Hospital, Gent, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: De Somer
authors.affiliation: Department of Cardiac Surgery, Ghent University Hospital, Gent, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Van Belleghem
authors.affiliation: Department of Anaesthesiology, Ghent University Hospital, Gent, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: De Hert
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D004311:Double-Blind Method; D005260:Female; D005780:Gelatin / Q000494:pharmacology*; D006438:Hemodilution / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D008297:Male; D055806:Microvessels / Q000187:drug effects*; D010952:Plasma Substitutes / Q000494:pharmacology*; D011446:Prospective Studies
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D005780:Gelatin
keywords: O2 delivery to tissues: factors impacting; cardiopulmonary bypass management; crystalloid vs colloid treatment