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 pentastarchhydroxyethyl 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% ITES (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. (C) 2008 Elsevier Inc. All rights reserved.