• Ann Fr Anesth Reanim · Jan 2010

    Clinical Trial

    [Assessment of efficacy of hypertonic saline - hydroxyethylstarch in haemorrhagic shock].

    • P Michelet, F Bouzana, D Couret, D Delahaye, G Perrin, L Dourlens, and J-P Auffray.
    • Réanimation des urgences, pôle réanimation urgences samu hyperbarie, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France. pierre.michelet@ap-hm.fr
    • Ann Fr Anesth Reanim. 2010 Jan 1;29(1):13-8.

    ObjectiveAssessment of haemodynamic, respiratory and renal effects of hypertonic saline-hydroxyethyl starch (HyperHES) in critically ill-patients with hemorrhagic shock.Patients And MethodsSeventeen mechanically ventilated patients with hemorragic shock benefiting from a cardiovascular monitoring by PiCCO device and requiring rapid volume loading. Two hundred and fifty milliliters of HyperHES were given over 5 minutes. The efficacy of volume loading was assessed by the measure of the systolic arterial pressure (SAP), cardiac index (CI), stroke volume variation (SVV) and the indexed systemic vascular resistance (iSVR). Studied parameters were assessed at baseline, 5, 30, 60 and 180 minutes after the end of HyperHES infusion.ResultsSAP (105 + or - 23 vs 77 + or - 10; p<0.001) and CI (4.8 + or - 1.1 vs 3.5 + or - 0.9; p<0.001) were significantly increased whereas iSVR (1175 + or - 310 vs 1501 + or - 337; p<0.01) and SVV (13 + or - 7 vs 20 + or - 5; p<0.01) were significantly decreased 5 minutes after the HyperHES infusion. Sodium (145 + or - 6 vs 136 + or - 5; p<0.001) and chloride (118 + or - 7 vs 107 + or - 6; p<0.001) were increased 5 minutes after the infusion. The PaO(2)/FiO(2) ratio as the extravascular lung water was not influenced by the infusion. The follow-up of renal parameters during the three first days (creatinemia, uremia and diuresis) did not revelead significant variations.ConclusionIn patients with hemorrhagic shock, the infusion of hypertonic saline (7.5%) hydroxyethyl starch association was followed by an increase in SAP, CI serum sodium and chloride concentrations.Study DesignProspective observational study.Copyright 2009 Elsevier Masson SAS. All rights reserved.

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