Effects of different substitution hydroxyethyl starch in volume replacement therapy on haemodynamic variables and blood coagulation functions

doi:10.3877/cma.j.issn.1674-0793.2011.03.003

Abstract

Abstract:

Objective

To investigate the effects of different substitution hydroxyethyl starch(HES) for general surgery patients in volume replacement therapy on haemodynamic variables and blood coagulation functions during operation.

Methods

Sixty-seven patients ASAⅠ-Ⅱ undergoing selective and non-cardiac surgery were assigned randomly to 3 groups:R1 group(6% HES130/0.4group, n=23), R1 group(6% HES200/0.5 group, n=24) and group C (Ringer locke liquor group, n=20), hemodynamic and blood coagulation data, the hemoglobin(Hb), blood platelet count(Plt), prothrombin time(PT), activated partial thromboplastin time(APTT) were measured on the day before operation and on the postoperative day 1.

Results

Hemodynamic variables had no significant difference with the baseline and during each stage time of surgery in each groups, HB, Plt, PT, APTT had no significant difference after the volume replacement therapy in each groups, P>0.05. Compared with group C, patients in R1 and R2 groups maintained stable haemodynamics with significant lower dose of infusion volume, P<0.05.

Conclusion

6%HES 130/0.4 and 6% HES200/0.5 in appropriate dose are safe and effective in volume replacement therapy,and they have little influence on blood coagulation functions.

Key words: Hydroxyethyl starch, Volume replacement therapy, Blood coagulation function

Nan JIANG, Sheng-hua DENG, Xiao-dan WU, Kang-qing XU, Wen-qi HUANG. Effects of different substitution hydroxyethyl starch in volume replacement therapy on haemodynamic variables and blood coagulation functions[J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(03): 191-194.

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Figures/Tables 3

References 11

1	Sinauridze EI, Bulanov Aiu, Gorbatenko AS, et al. Enhancement of coagulation caused by transfusion of artificial plasma-replacement solutions. Ter Arkh, 2009, 81(1): 52-56.
2	De Lorenzo C,Calatzis A，Welsch U, et al. Fibrinogen concentrate reverses dilutional coagulopathy induced in vitro by saline but not by hydroxyethyl starch 6%.Anesth Analg, 2006, 102(4): 1194-2000.
3	Petroianu GA, Maleck WH, Koetter KP, et al. Effect of in vitro hemodilution with hydroxyethyl starch and dextran on the activity of plasma clotting factors. Crit Care Med, 2003, 31(1): 250-254.
4	Asskali F, Lehmann G, Forster H. Thrombelastographic coagulation analysis following in vitro and in vivo haemodilution with hydroxyethyl starch (HES).Anaesthasiol Intensived Notfallmed Schmerzther, 2002, 37(5): 258-266.
5	Entholzner EK, Mielke LL, Calatzis AN, et al. Coagulation effects of a recently developed hydroxyethyl starch (HES 130/0.4) compared to hydroxyethyl starches with higher molecular weight. Acta Anaesthesiol Scand, 2000, 44(9): 1116-1121.
6	Standl T, Burmeister MA, Schroeder F, et al. Hydroxyethyl starch (HES) 130/0.4 provides larger and faster increases in tissue oxygen tension in comparison with prehemodilution values than HES 70/0.5 or HES 200/0.5 in volunteers undergoing acute normovolemic hemodilution. Anesth Analg, 2003, 96(4): 936-943.
7	Gallandat Huet RC, Siemons AW, Baus D, et al. A novel hydroxyethyl starch (Voluven) for effective perioperative plasma volume substitution in cardiac surgery. Can J Anaesth, 2002, 47(12): 1207-1215.
8	Langeron O, Doelberg M, Ang ET, et al. Voluven, a lower substituted novel hydroxyethyl starch (HES 130/0.4) causes fewer effects on coagulation in major orthopedic surgery than HES 200/0.5. Anesth Analg, 2001, 92(4): 855-862.
9	Huttner I, Boldt J, Haisch G, et al. Influence of different colloids on molecular markers of haemostasis and platelet function in patients undergoing major abdominal surgery. Br J Anaesth, 2000, 85(3): 417-423.
10	徐雪，赵砚丽，程会平, 等. 人工血浆代用品对凝血和纤溶功能的影响. 中华麻醉学杂志, 2000, 20(9): 520-523.
11	Liu FC, Liao CH, Chang YW, et al. Hydroxyethyl starch interferes with human blood ex vivo coagulation, platelet function and sedimentation. Acta Anaesthesiol Taiwan, 2009, 47(2): 71-78.

组别	HES用量（ml）	液体总输入量（ml）	红细胞输入量（ml）	血浆输入量（ml）	出血量（ml）	尿量（ml）
R1组	1337±478	3283±1891^*	926±720	429±180	846±863	759±521
R2组	1313±421	3581±2771^*	993±927	570±506	955±934	810±777
C组	-	4316±165	1022±1051	517±572	915±987	730±422

组别	HES用量（ml）	液体总输入量（ml）	红细胞输入量（ml）	血浆输入量（ml）	出血量（ml）	尿量（ml）
R1组	1337±478	3283±1891^*	926±720	429±180	846±863	759±521
R2组	1313±421	3581±2771^*	993±927	570±506	955±934	810±777
C组	-	4316±165	1022±1051	517±572	915±987	730±422

组别		T1-T0（差值）	T2-T0（差值）	T3-T0（差值）
R1组		?	?	?
?	HR(bpm)	-5.3±12.9	3.0±11.3	3.8±12.9
?	MAP(mm Hg)	-12.1±22.0	-4.1±28.0	-10.7±11.2
?	CVP(cm H₂O)	0.6±0.6	2.4±2.8	-4.5±3.3
R2组		?	?	?
?	HR(bpm)	-8.3±13.7	-0.5±17. 5	0.4±14.9
?	MAP(mm Hg)	-18.6±21.2	-4.1±20.6	-9.3±19. 2
?	CVP(cm H₂O)	0.3±1.0	-2.2±2.7	-4.8±2.2
C组		?	?	?
?	HR(bpm)	-6.3±11.5	9.3±13.5	26.2±22.4
?	MAP(mm Hg)	-10.3±13.2	-14.3±18. 2	-10.7±11.2
?	CVP(cmH₂O)	-1.1±1.2	-1.7±1.1	-15.4±24.8

组别		T1-T0（差值）	T2-T0（差值）	T3-T0（差值）
R1组		?	?	?
?	HR(bpm)	-5.3±12.9	3.0±11.3	3.8±12.9
?	MAP(mm Hg)	-12.1±22.0	-4.1±28.0	-10.7±11.2
?	CVP(cm H₂O)	0.6±0.6	2.4±2.8	-4.5±3.3
R2组		?	?	?
?	HR(bpm)	-8.3±13.7	-0.5±17. 5	0.4±14.9
?	MAP(mm Hg)	-18.6±21.2	-4.1±20.6	-9.3±19. 2
?	CVP(cm H₂O)	0.3±1.0	-2.2±2.7	-4.8±2.2
C组		?	?	?
?	HR(bpm)	-6.3±11.5	9.3±13.5	26.2±22.4
?	MAP(mm Hg)	-10.3±13.2	-14.3±18. 2	-10.7±11.2
?	CVP(cmH₂O)	-1.1±1.2	-1.7±1.1	-15.4±24.8

组别		术前1 d	术后1 d
R1组		?	?
?	Hb（g/L）	13.0±1.5	11.2±1.8
?	Plt(×10⁹/L)	240.5±99.9	189.5±87.0
?	PT(s)	11.2±1.2	13.4±1.7
?	APTT(s)	28.0±14.4	32.6±13.1
R2组		?	?
?	Hb（g/L）	13.1±1.9	10.8±1.4
?	Plt(×10⁹/L)	225.2±86.7	174.3±77.3
?	PT(s)	12.1±1.3	14.0±1.7
?	APTT(s)	30.3±18.5	33.9±11.8
C组		?	?
?	Hb（g/L）	12.5±9.7	11.5±1.0
?	Plt(×10⁹/L)	229.9±40.3	138.2±71.3
?	PT(s)	12.0±2.1	14.4±1.5
?	APTT(s)	35.4±2.3	32.1±12. 7

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