The intraoperative therapeutic equivalence of balanced vs saline-based 6% hydroxyethyl starch 130/0.4 and their influence on perioperative acid-base status and renal functions.
OBJECTIVE
This study was designed to evaluate the therapeutic equivalence of balanced 6% hydroxyethyl starch (HES) 130/0.4 (Tetraspan) vs saline-based 6% HES 130/0.4 (Voluven) regarding the volume effect and the effect on acid-base status and renal functions in patients undergoing major urologic procedures.


METHODS
Randomized comparative trial.


METHODS
Operating room and ward.


METHODS
Forty patients, American Society of Anesthesiologists statuses 1 and 2.


METHODS
Patients were randomly allocated to receive either Voluven (n = 20) or Tetraspan (n = 20).


METHODS
Hemodynamic variables. Laboratory variables in the form of arterial blood gases, serum chloride and sodium levels, hemoglobin level, international normalized ratio, and kidney and liver functions were measured after induction of anesthesia (T1), at the end of surgery (T2), and on the first postoperative day (T3).


RESULTS
Both groups were comparable regarding the total amount of study drugs and crystalloid consumption. No significant difference in hemoglobin levels between both groups, but there were significant differences between T1 and T2 hemoglobin within both groups and T3 hemoglobin in the Tetraspan group. Both groups were comparable regarding the renal functions, but there was a significant difference between T1 and T2 creatinine within both groups. No significant differences between both groups in liver functions and coagulation profile, but there were significant differences between values at T1, T2 and T3 within each group. Relative to baseline, both pH and bicarbonate decrease significantly in both groups. In the Voluven group, bicarbonate decreased significantly at the end of surgery relative to the Tetraspan group. Serum electrolytes did not vary between both groups.


CONCLUSIONS
Both balanced 6% HES 130/0.4 (Tetraspan) and saline-based 6% HES 130/0.4 (Voluven) were equally effective for hemodynamic stabilization of patients undergoing major urologic procedures without any significant impact on acid-base status or renal functions.
Anesthesia & SICU Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed
A
Helmy
Anesthesia & SICU Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed
A
Mukhtar
Anesthesia & SICU Department, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: abeer_ahmed@kasralainy.edu.eg.
Abeer
A
Ahmed
Anesthesia & SICU Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Nazmy Edward
NE
Sief
Anesthesia & SICU Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amr
A
Hussein
D000136:Acid-Base Equilibrium / Q000187:drug effects*; D001784:Blood Gas Analysis; D000077324:Crystalloid Solutions; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007430:Intraoperative Care / Q000379:methods*; D007552:Isotonic Solutions / Q000494:pharmacology*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000494:pharmacology*; D011446:Prospective Studies
D000077324:Crystalloid Solutions; C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes
Colloids; Crystalloids; Hydroxyethyl starch; Intraoperative fluid; Safety; Volume effect