Effects of polygeline and hydroxyethyl starch solutions on liver functions assessed with LIMON in hypovolemic patients


Inal M. T., MEMİŞ D., Karamanlioglu B., SÜT N.

Journal of Critical Care, cilt.25, sa.2, 2010 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 2
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1016/j.jcrc.2009.06.013
  • Dergi Adı: Journal of Critical Care
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: Indocyanine green, Plasma disappearance rate, Colloid solutions
  • Trakya Üniversitesi Adresli: Evet

Özet

Background: Hypovolemia is a common clinical entity in critical patients, and adequate volume replacement therapy seems to be essential for maintaining tissue perfusion. However, it is still uncertain which solution is most appropriate for fluid resuscitation. Objective: The aim of this study was to investigate the effects of fluid resuscitation with 3.5% polygeline versus 6% hydroxyethyl starch solutions on hemodynamic functions and liver functions assessed with a noninvasive liver function monitoring system (LIMON) in hypovolemic patients. Design: This study is a prospective randomized clinical trial. Measurements and Results: Thirty hypovolemic patients (intrathoracic blood volume index, <850 mL/m2) were randomized into hydroxyethyl starch (mean molecular weight, 130 000 Da) and polygeline (mean molecular weight, 30 000 Da) groups (15 patients each). Indocyanine green plasma disappearance elimination (ICG-PDR) were conducted concurrently using LIMON. A dose of 0.3 mg/kg ICG was given through a cubital fossa vein as a bolus. For fluid resuscitation, 500 mL of colloid was given to the patients. Repeated hemodynamic and ICG-PDR measurements were done at baseline, after infusion, and then at 30 minutes after infusion. Results: Intrathoracic blood volume index and systolic, diastolic, and mean blood pressures increased significantly after infusion and remained elevated for 30 minutes after infusion, but there was no significant difference between the 2 groups. Indocyanine green plasma disappearance elimination values were similar in both groups with no significant difference between the two. Conclusion: Increasing intrathoracic blood volume index and hemodynamic variables by fluid loading is not associated with a significant change in ICG-PDR. © 2010 Elsevier Inc.