Hemodynamics effects of volemic replacement with normal saline hypertonic hydroxyethil starch solution : experimental study in hypovolemics dog / Efeitos hemodinamicos da reposição volemica com solução de hidroxil-etil amido hipertonico : estudo experimental em cães hipovolemicos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Background and Objectives: Several solutions may be employed for the treatment of hypovolemia. Among the various solutions used, the most common are crystalloids and colloids. In the 80s, the use of hypertonic saline solutions was studied for small-volume fluid replacement. Subsequently, these hypertonic solutions were associated with colloid solutions producing satisfactory results. Hypertonic hydroxyethyl starch is a new solution used for volume replacement that is composed of a colloid associated with 7.2% NaCl. The purpose of this study was to examine hemodynamic response to volume replacement using saline solution and hypertonic hydroxyethyl starch in dogs subjected to hypovolemia. Method: Forty (40) dogs underwent general anesthesia and were hemodynamically monitored with intra-arterial blood pressure monitoring and a Swan-Ganz catheter. Baseline hemodynamic values were measured and the dogs were bled 20 ml.Kg.1 Parameters were measured after 10 minutes. Volume replacement with saline solution was then performed at a ratio of twice the volume removed or 4 ml.Kg-1 of hypertonic hydroxyethyl starch. Hemodynamic data was measured after 5, 15, 30, 45 and 60 minutes. The results were statistically compared. Results: In this study, values returned to satisfactory hemodynamic levels when volume was replaced with both solutions. Higher initial values were observed when saline solution was used. However, these values tended to decrease progressively. When hypertonic hydroxyethyl starch was used, the parameters studied returned more rapidly to values similar to those at baseline and less variation was observed. The cardiac index showed higher values for the saline group at all time periods studied after volume replacement (p<0.001). Arterial blood pressure and pulmonary blood pressure showed no differences between groups. Pulmonary capillary pressure and central venous pressure showed higher values for the saline group immediately after volume replacement (M3). Conclusions: Both solutions proved to be efficient at replacing volume in the short period studied. However, hypertonic hidroxyethyl starch provided more stable results. Uniterms: Hypovolemia, Hetastarch, Saline Solution, Hypertonic

ASSUNTO(S)

hetastarch saline solution hipovolemia hypertonic solução salina hipertonica hidroxietil amido

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