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Hemodynamic effects of 6% and 10% hydroxyethyl starch solutions versus 4% albumin solution in septic patients
Gilberto Friedman1, Stanislaw Jankowski, Mohammad Shahla
1Department of Intensive Care, Erasme Hospital and Université libra de Bruxelles, Brussels, Belgium.
Study Objective:
To compare the hemodynamic effects of two different concentrations of pentastarch hydroxyethyl starch (HES; 200/0.5) solutions with a 4% human albumin solution for fluid resuscitation.
Design:
Open-label, randomized, controlled study.
Setting:
Medical-surgical intensive care unit.
Patients:
34 consecutive, hemodynamically stable, adult patients with sepsis and suspected hypovolemia.
Interventions:
Patients received a 400 mL infusion of either 10% HES (n = 11), 6% HES (n = 10), or 4% albumin (n = 13) over 40 minutes.
Measurements:
Hemodynamic and blood data were collected 40, 70, 100, and 160 minutes after the start of the fluid challenge.
Main Results:
Cardiac index, stroke volume index, and left ventricular stroke work index increased more in the 10% HES group than the 6% HES or albumin groups (P < 0.05). Oxygen delivery increased only in the 10% HES group. A decrease in hemoglobin concentration occurred in all three groups but was greatest in the 10% HES group.
Conclusions:
HES is as effective as albumin for volume resuscitation in septic patients.
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