Hemodynamic effects of 6% and 10% hydroxyethyl starch solutions versus 4% albumin solution in septic patients.

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.