Rackow E C, Mecher C, Astiz M E, Griffel M, Falk J L, Weil M H
Department of Medicine, University of Health Sciences, Chicago Medical School, IL 60064.
Crit Care Med. 1989 May;17(5):394-8. doi: 10.1097/00003246-198905000-00003.
Twenty consecutive patients with severe sepsis were randomized to fluid challenge with 5% albumin or 10% low MW hydroxyethyl starch (pentastarch) solutions. Fluid challenge was administered iv as 250 ml of test colloid every 15 min until the pulmonary artery wedge pressure (WP) was greater than or equal to 15 mm Hg or a maximum dose of 2000 ml was infused. Hemodynamic, respiratory, and coagulation profiles were measured before and after fluid infusion. The amount of colloid required to achieve a WP of 15 mm Hg was comparable between groups. Both colloid infusions resulted in similar increases in cardiac output, stroke output, and stroke work. The effect of fluid infusion with pentastarch on coagulation was not significantly different from albumin, although pentastarch was associated with a 45% decrease in factor VIII:c. We conclude that pentastarch is equivalent to albumin for fluid resuscitation of patients with severe sepsis.
20例连续性严重脓毒症患者被随机分为两组，分别接受5%白蛋白或10%低分子量羟乙基淀粉（万汶）溶液进行液体冲击治疗。以静脉输注方式进行液体冲击，每15分钟输注250ml试验胶体溶液，直至肺动脉楔压（WP）≥15mmHg或输注达到最大剂量2000ml。在液体输注前后测量血流动力学、呼吸和凝血指标。两组达到15mmHg肺动脉楔压所需的胶体量相当。两种胶体输注均使心输出量、每搏输出量和每搏功出现相似程度的增加。尽管万汶使凝血因子VIII:c降低了45%，但万汶液体输注对凝血的影响与白蛋白无显著差异。我们得出结论，在严重脓毒症患者的液体复苏方面，万汶与白蛋白等效。
