Tigchelaar I, Gallandat Huet R C, Boonstra P W, van Oeveren W
Blood Interaction Research, University Hospital Groningen, The Netherlands.
Perfusion. 1998 Sep;13(5):297-303. doi: 10.1177/026765919801300503.
Ten per cent low molecular weight hydroxyethyl starch is a plasma substitute only recently used as priming solution in an extracorporeal circuit, in contrast to human albumin and gelatin. To evaluate the effect of priming solutions on haemodynamics and colloid osmotic pressure, we studied 36 patients elected for cardiopulmonary bypass (CPB). They were randomly assigned to 2.5% hydroxyethyl starch, 3% gelatin or 4% human albumin priming solution. Total blood loss (perioperative + intensive care unit period) was higher in the gelatin group than in the albumin and hydroxyethyl starch groups. During CPB, the colloid osmotic pressure was best preserved in the gelatin group, although no excessively low colloid osmotic pressures were measured in the other two groups. Due to the extended half-life and the additional postoperative colloid administration, the hydroxyethyl starch group had a higher colloid osmotic pressure in the postoperative phase. We conclude that, next to human albumin, 2.5% hydroxyethyl starch is a safe CPB priming solution additive and is effective as plasma substitute. Its somewhat longer half-life requires adaptation of the routine protocol for transfusion of colloids and blood products.
与人体白蛋白和明胶不同，10%低分子量羟乙基淀粉是一种最近才在体外循环中用作预充液的血浆代用品。为了评估预充液对血流动力学和胶体渗透压的影响，我们研究了36例择期进行体外循环（CPB）的患者。他们被随机分配到2.5%羟乙基淀粉、3%明胶或4%人体白蛋白预充液组。明胶组的总失血量（围手术期+重症监护病房期）高于白蛋白组和羟乙基淀粉组。在CPB期间，尽管其他两组未测得过低的胶体渗透压，但明胶组的胶体渗透压保存最佳。由于半衰期延长以及术后额外给予胶体，羟乙基淀粉组在术后阶段的胶体渗透压较高。我们得出结论，除人体白蛋白外，2.5%羟乙基淀粉是一种安全的CPB预充液添加剂，并且作为血浆代用品是有效的。其半衰期稍长需要调整胶体和血液制品输注的常规方案。
