Munsch C M, MacIntyre E, Machin S J, Mackie I J, Treasure T
Department of Cardiothoracic Surgery, Middlesex Hospital, London, UK.
Br J Surg. 1988 Jul;75(7):675-8. doi: 10.1002/bjs.1800750717.
Hydroxyethyl starch (HES) is a recently developed synthetic volume expander. Forty patients undergoing coronary artery surgery were randomized to receive either HES or plasma protein fraction (PPF) as non-blood volume replacement according to standard haemodynamic criteria. The two groups were comparable in all respects. The median colloid use in the first 24 h was 950 ml (range 500-1500) in the HES group and 975 ml (350-2000) in the PPF group (not significant). There was no difference in blood use, urine output or blood loss between the two groups. Tests of coagulation showed the postoperative changes usual in cardiac surgical patients. There was no difference between the two groups in thrombin time, prothrombin time, activated partial thromboplastin time, or fibrinogen concentration. Similarly, tests of platelet function and Factor VIII and von Willebrand Factor activity showed no difference between the two groups. We conclude that HES is a safe and effective volume expander, and its relative lack of expense and ease of availability make its routine use after cardiac surgery an attractive proposition.
羟乙基淀粉（HES）是一种最近研发的合成胶体扩容剂。40例行冠状动脉手术的患者，根据标准血流动力学标准随机接受HES或血浆蛋白成分（PPF）作为非血液容量替代物。两组在各方面均具有可比性。HES组在前24小时胶体的中位用量为950毫升（范围500 - 1500），PPF组为975毫升（350 - 2000）（无显著差异）。两组在输血量、尿量或失血量方面无差异。凝血检查显示为心脏手术患者常见的术后变化。两组在凝血酶时间、凝血酶原时间、活化部分凝血活酶时间或纤维蛋白原浓度方面无差异。同样，血小板功能以及因子VIII和血管性血友病因子活性检查显示两组之间无差异。我们得出结论，HES是一种安全有效的扩容剂，其相对较低的成本和易于获取使其在心脏手术后常规使用成为一个有吸引力的选择。
