Friedman Gilberto, Jankowski Stanislaw, Shahla Mohammad, Gomez Jussara, Vincent Jean-Louis
Department of Intensive Care, Erasme Hospital and Université libra de Bruxelles, Brussels, Belgium.
J Clin Anesth. 2008 Nov;20(7):528-33. doi: 10.1016/j.jclinane.2008.05.022. Epub 2008 Nov 20.
To compare the hemodynamic effects of two different concentrations of pentastarch hydroxyethyl starch (HES; 200/0.5) solutions with a 4% human albumin solution for fluid resuscitation.
Open-label, randomized, controlled study.
Medical-surgical intensive care unit.
34 consecutive, hemodynamically stable, adult patients with sepsis and suspected hypovolemia.
Patients received a 400 mL infusion of either 10% HES (n = 11), 6% HES (n = 10), or 4% albumin (n = 13) over 40 minutes.
Hemodynamic and blood data were collected 40, 70, 100, and 160 minutes after the start of the fluid challenge.
Cardiac index, stroke volume index, and left ventricular stroke work index increased more in the 10% HES group than the 6% HES or albumin groups (P < 0.05). Oxygen delivery increased only in the 10% HES group. A decrease in hemoglobin concentration occurred in all three groups but was greatest in the 10% HES group.
HES is as effective as albumin for volume resuscitation in septic patients.
比较两种不同浓度的羟乙基淀粉（HES；200/0.5）溶液与4%人白蛋白溶液用于液体复苏时的血流动力学效应。
开放标签、随机对照研究。
内科-外科重症监护病房。
34例连续的、血流动力学稳定的成年脓毒症患者且怀疑存在血容量不足。
患者在40分钟内接受400毫升的10% HES（n = 11）、6% HES（n = 10）或4%白蛋白（n = 13）输注。
在液体冲击开始后40、70、100和160分钟收集血流动力学和血液数据。
10% HES组的心脏指数、每搏量指数和左心室每搏功指数比6% HES组或白蛋白组增加更多（P < 0.05）。仅10% HES组的氧输送增加。三组患者的血红蛋白浓度均降低，但10% HES组降低幅度最大。
在脓毒症患者中，HES用于容量复苏的效果与白蛋白相当。
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