Fluid resuscitation with colloids of different molecular weight in septic shock
Autor: | Tamas Szakmany, Tamas Leiner, A Mikor, Zsolt Molnár |
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Jazyk: | angličtina |
Rok vydání: | 2004 |
Předmět: |
Adult
Male medicine.medical_specialty Resuscitation Hemodynamics Hydroxyethyl starch Lung injury Critical Care and Intensive Care Medicine Hydroxyethyl Starch Derivatives Intensive care medicine Humans In patient Colloids Prospective Studies Respiratory Distress Syndrome Septic shock business.industry Oxygen Inhalation Therapy Oxygenation Middle Aged respiratory system medicine.disease Shock Septic respiratory tract diseases Surgery Molecular Weight Treatment Outcome Anesthesia Extravascular Lung Water Poster Presentation Fluid Therapy Gelatin Female business Gels medicine.drug |
Zdroj: | Critical Care Europe PubMed Central |
ISSN: | 1466-609X 1364-8535 |
Popis: | The aim of this study was to investigate the short-term effect of fluid resuscitation with 4% modified fluid gelatine (GEL) versus 6% hydroxyethyl starch (HES) on haemodynamics and oxygenation in patients with septic shock and acute lung injury (ALI).Prospective randomised clinical trial.Twenty-bed intensive care unit in a university hospital.Thirty hypovolemic patients (intrathoracic blood volume index, ITBVI850 ml/m(2)) in septic shock with ALI were randomised into HES (mean molecular weight: 200,000 Dalton, degree of substitution 0.6) and GEL (mean molecular weight: 30,000 Dalton) groups (15 patients each).For fluid resuscitation 250 ml/15 min boluses (max. 1,000 ml) were given until the end point of ITBVI900 ml/m(2) was reached. Repeated haemodynamic measurements were done at baseline (t(b)), at the end point (t(ep)) then at 30 min and 60 min after the end point was reached (t(30), t(60)). Cardiac output, stroke volume, extravascular lung water (EVLW), and oxygen delivery was determined at each assessment point. For statistical analysis two-way ANOVA was used.ITBVI, cardiac index, and oxygen delivery index increased significantly at t(ep) and remained elevated for t(30) and t(60), but there was no significant difference between the two groups. The increase in the ITBVI by 100 ml of infusion was similar in both groups (HES: 26+/-19 ml/m(2) vs GEL: 30+/-19 ml/m(2)). EVLW, remained unchanged, and there was no significant difference between the groups (HES, t(b): 8+/-6, t(60): 8+/-6; GEL, t(b): 8+/-3, t(60): 8+/-3 ml/kg). The PaO(2)/FiO(2) did not change significantly over time or between groups (HES, t(b): 207+/-114, t(60): 189+/-78; GEL, t(b): 182+/-85, t(60): 182+/-85 mmHg).The results of this study indicate that both HES and GEL infusions caused similar short-term change in ITBVI in septic shock, without increasing EVLW or worsening oxygenation. |
Databáze: | OpenAIRE |
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