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[Hypertonic-hyperoncotic volume replacement (7.5% NaCl/10% hydroxyethyl starch 200.000/0.5) in patients with coronary artery stenoses].
Zentralbl Chir. 1993; 118(5):257-63; discussion 264-6.ZC

Abstract

OBJECTIVES

To determine the efficacy and safety of intravascular volume augmentation with a hypertonic saline-hyperoncotic HES solution prior to CABG.

DESIGN

Randomized, double-blind, clinical trial.

PATIENTS

Consecutive sample of 37 patients scheduled for elective CABG; mean age 64.5 (41-80; range) years and weight 74 (51-111) kg.

INTERVENTIONS

Continuous, central-venous infusion of either 250 ml (approx. 3.5 ml/kg) HES (0.9% NaCl/10% hydroxyethyl starch 200.000/0.5) or HT-HES (7.5% NaCl/10% hydroxyethyl starch 200.000/0.5) in 15 minutes, following induction of anesthesia.

MEASUREMENTS AND MAIN RESULTS

Groups were similar with respect to age, weight, and sex. 15 min. after fluid loading, cardiac index, pulmonary artery pressure, and wedge pressure had increased from baseline in both groups (p < 0.05), with a greater increase in the HT-HES-group (p < 0.05). In eight out of 18 patients, who had received HT-HES, transient drops in arterial blood pressure (mean 20% from baseline, range 10-35%) were observed during the first 5 minutes of infusion. Seven of the HT-HES-group patients developed transient left ventricular failure, predominantly 5-20 min. after infusion. No incidence of initial hypotension or LVF was observed in the HES-group.

CONCLUSIONS

In patients with coronary artery disease, volume augmentation with hypertonic-hyperoncotic solutions may induce transient hypotension and post-infusion hypervolemic left heart failure.

Authors+Show Affiliations

Prien T
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälischen Wilhelms-Universität Münster.
Thülig B
No affiliation info available
Wüsten R
No affiliation info available
Schoofs J
No affiliation info available
Weyand M
No affiliation info available
Lawin P
No affiliation info available

MeSH

AdultAgedBlood VolumeCoronary Artery BypassCoronary DiseaseDouble-Blind MethodExtracorporeal CirculationFemaleHematocritHemodynamicsHumansHydroxyethyl Starch DerivativesHypertonic SolutionsMaleMiddle AgedOxygenSaline Solution, HypertonicWater-Electrolyte Balance

Pub Type(s)

Clinical Trial
English Abstract
Journal Article
Randomized Controlled Trial

Language

ger

PubMed ID

7686707

Citation

Prien, T, et al. "[Hypertonic-hyperoncotic Volume Replacement (7.5% NaCl/10% Hydroxyethyl Starch 200.000/0.5) in Patients With Coronary Artery Stenoses]." Zentralblatt Fur Chirurgie, vol. 118, no. 5, 1993, pp. 257-63; discussion 264-6.
Prien T, Thülig B, Wüsten R, et al. [Hypertonic-hyperoncotic volume replacement (7.5% NaCl/10% hydroxyethyl starch 200.000/0.5) in patients with coronary artery stenoses]. Zentralbl Chir. 1993;118(5):257-63; discussion 264-6.
Prien, T., Thülig, B., Wüsten, R., Schoofs, J., Weyand, M., & Lawin, P. (1993). [Hypertonic-hyperoncotic volume replacement (7.5% NaCl/10% hydroxyethyl starch 200.000/0.5) in patients with coronary artery stenoses]. Zentralblatt Fur Chirurgie, 118(5), 257-63; discussion 264-6.
Prien T, et al. [Hypertonic-hyperoncotic Volume Replacement (7.5% NaCl/10% Hydroxyethyl Starch 200.000/0.5) in Patients With Coronary Artery Stenoses]. Zentralbl Chir. 1993;118(5):257-63; discussion 264-6. PubMed PMID: 7686707.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hypertonic-hyperoncotic volume replacement (7.5% NaCl/10% hydroxyethyl starch 200.000/0.5) in patients with coronary artery stenoses]. AU - Prien,T, AU - Thülig,B, AU - Wüsten,R, AU - Schoofs,J, AU - Weyand,M, AU - Lawin,P, PY - 1993/1/1/pubmed PY - 1993/1/1/medline PY - 1993/1/1/entrez SP - 257-63; discussion 264-6 JF - Zentralblatt fur Chirurgie JO - Zentralbl Chir VL - 118 IS - 5 N2 - OBJECTIVES: To determine the efficacy and safety of intravascular volume augmentation with a hypertonic saline-hyperoncotic HES solution prior to CABG. DESIGN: Randomized, double-blind, clinical trial. PATIENTS: Consecutive sample of 37 patients scheduled for elective CABG; mean age 64.5 (41-80; range) years and weight 74 (51-111) kg. INTERVENTIONS: Continuous, central-venous infusion of either 250 ml (approx. 3.5 ml/kg) HES (0.9% NaCl/10% hydroxyethyl starch 200.000/0.5) or HT-HES (7.5% NaCl/10% hydroxyethyl starch 200.000/0.5) in 15 minutes, following induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Groups were similar with respect to age, weight, and sex. 15 min. after fluid loading, cardiac index, pulmonary artery pressure, and wedge pressure had increased from baseline in both groups (p < 0.05), with a greater increase in the HT-HES-group (p < 0.05). In eight out of 18 patients, who had received HT-HES, transient drops in arterial blood pressure (mean 20% from baseline, range 10-35%) were observed during the first 5 minutes of infusion. Seven of the HT-HES-group patients developed transient left ventricular failure, predominantly 5-20 min. after infusion. No incidence of initial hypotension or LVF was observed in the HES-group. CONCLUSIONS: In patients with coronary artery disease, volume augmentation with hypertonic-hyperoncotic solutions may induce transient hypotension and post-infusion hypervolemic left heart failure. SN - 0044-409X UR - https://www.unboundmedicine.com/medline/citation/7686707/[Hypertonic_hyperoncotic_volume_replacement__7_5_NaCl/10_hydroxyethyl_starch_200_000/0_5__in_patients_with_coronary_artery_stenoses]_ L2 - https://medlineplus.gov/coronaryarterybypasssurgery.html DB - PRIME DP - Unbound Medicine ER -
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