Comparison of 6% hydroxyethyl starch 130/0.4 and saline solution for resuscitation of the microcirculation during the early goal-directed therapy of septic patients.
Comparison of 6% hydroxyethyl starch 130/0.4 and saline solution for resuscitation of the microcirculation during the early goal-directed therapy of septic patients.
复制标题
DOI：
10.1016/j.jcrc.2010.04.007
复制
发表时间：
2010-12-01
影响因子：
3.7
通讯作者：
Ince, Can
中科院分区：
文献类型：
--
作者：
Dubin, Arnaldo;Pozo, Mario O;Ince, Can
目得：本研究的目的是表明，6%羟乙基淀粉（HES）130/0.4实现了更好的复苏的微循环比生理盐水溶液（SS），在早期目标导向治疗（EGDT）在脓毒症patients.MATERIALS和METHODS：严重脓毒症患者随机EGDT与6%HES 130/0.4（n = 9）或SS（n = 11）。舌下微循环评价侧流暗场成像24小时后开始EGDT.RESULTS：入院时，有没有差异，序贯器官衰竭评估评分，平均动脉压，乳酸，或中心静脉血氧饱和度。24小时后，这些参数无差异。两组舌下毛细血管密度相似（21 ± 8 vs. 20 ± 3支血管/mm（2））;而6%HES 130/0.4组的毛细血管血流指数、毛细血管灌注百分比和毛细血管灌注密度均高于对照组（2.5 ± 0.5 vs. 1.6 ± 0.7，84 ± 15 vs. 53 ± 26%，19 ± 6 vs. 11 ± 5 vessels/mm（2），P <0.005）。结论：6%HES 130/0.4液体复苏在改善舌下微循环方面优于SS。需要更多的患者来证实这些发现。
PURPOSE: The aim of this study was to show that 6% hydroxyethyl starch (HES) 130/0.4 achieves a better resuscitation of the microcirculation than normal saline solution (SS), during early goal-directed therapy (EGDT) in septic patients.MATERIALS AND METHODS: Patients with severe sepsis were randomized for EGDT with 6% HES 130/0.4 (n = 9) or SS (n = 11). Sublingual microcirculation was evaluated by sidestream dark field imaging 24 hours after the beginning of EGDT.RESULTS: On admission, there were no differences in Sequential Organ Failure Assessment score, mean arterial pressure, lactate, or central venous oxygen saturation. After 24 hours, no difference arose in those parameters. Sublingual capillary density was similar in both groups (21 ± 8 versus 20 ± 3 vessels/mm(2)); but capillary microvascular flow index, percent of perfused capillaries, and perfused capillary density were higher in 6% HES 130/0.4 (2.5 ± 0.5 versus 1.6 ± 0.7, 84 ± 15 versus 53 ± 26%, and 19 ± 6 versus 11 ± 5 vessels/mm(2), respectively, P < .005).CONCLUSIONS: Fluid resuscitation with 6% HES 130/0.4 may have advantages over SS to improve sublingual microcirculation. A greater number of patients would be necessary to confirm these findings.