Use of modified fluid gelatin and hydroxyethyl starch for colloidal volume replacement in major orthopaedic surgery
Use of modified fluid gelatin and hydroxyethyl starch for colloidal volume replacement in major orthopaedic surgery
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DOI：
10.1093/bja/78.1.44
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发表时间：
1997-01-01
影响因子：
9.8
通讯作者：
Kettler, D
中科院分区：
文献类型：
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作者：
Beyer, R;Harmening, U;Kettler, D
我们比较了5%羟乙基淀粉(HES 200/0.5)和3%改良液体明胶(MFG)在骨科大手术中的容量替代效果，并研究了它们对血流动力学、胶体渗透压、凝血和血浆稳态的影响。采用对照、随机、单盲的临床设计，我们研究了连续46例接受大型骨科髋关节手术的患者。两组在年龄、体重和手术时间方面具有可比性。在整个研究期间，使用HES和MFG的患者都保持了血液动力学的稳定，两组的液体平衡和胶体替代量相似(围手术期输液量的中位数：HES 2500毫升，MFG 2400毫升)。实验室变量在临床上没有不同。我们得出结论，两种胶体溶液在容量有效性以及对血浆肿胀压、凝血和血浆内稳态的影响方面具有可比性。在研究的少数患者中，5%HES 200/0.5的剂量被发现是安全的，剂量相当于德国和法国目前接受的每日最大剂量分别为33毫升/公斤体重和2.0克/公斤体重。
We have compared 5% hydroxyethyl starch (HES 200/0.5) with 3% modified fluid gelatin (MFG) for volume replacement in major orthopaedic surgery and studied the effects on haemodynamic stare, colloid osmotic pressure, blood clotting and plasma homeostasis. Using a controlled, randomized, single-blind clinical design, we studied 46 consecutive patients undergoing major elective orthopaedic hip surgery. The two groups were comparable in age, body weight and duration of surgery. Patients were maintained haemodynamically stable using both HES and MFG over the entire study, Fluid balance and colloidal replacement volumes were comparable in both groups (median perioperative infusion volume: HES 2500 ml, MFG 2400 ml). Laboralory variables were not clinically different. We conclude that both colloidal solutions were comparable in volume efficacy and effects on plasma oncotic pressure, clotting and plasma homeostasis. In the small number of patients studied, 5% HES 200/0.5 was found to be safe when administered in amounts corresponding to the currently accepted maximum daily dose in Germany and France of 33 ml/kg body weight and 2.0 g/kg body weight, respectively.