Large-dose hydroxyethyl starch 130/0.4 does not increase blood loss and transfusion requirements in coronary artery bypass surgery compared with hydroxyethyl starch 200/0.5 at recommended doses.

Abstract:

BACKGROUND:Hydroxyethyl starch (HES) 130/0.4 may impair blood coagulation less than other HES solutions and, thus, may be used at larger doses without increasing the risk of postoperative bleeding. This study tested the hypothesis that volume replacement with 6% HES 130/0.4 at a dose of up to 50 ml/kg does not increase blood loss and transfusion requirements in elective coronary artery bypass surgery compared with 6% HES 200/0.5 at a dose of up to 33 ml/kg. METHODS:One hundred twenty adult patients scheduled for elective coronary artery bypass surgery were randomized to receive up to 50 ml/kg of 6% HES 130/0.4 or up to 33 ml/kg of 6% HES 200/0.5 for volume replacement during surgery and until 24 h thereafter. Volume requirements in excess of the respective maximum dose of HES were treated with gelatin. Colloid use was at the discretion of the attending physicians and not dictated by protocol. The primary outcome variable was chest tube drainage volume during the first 24 h after surgery. RESULTS:The data from 117 patients (HES 130/0.4, 59 patients; HES 200/0.5, 58 patients) who completed the study according to protocol were analyzed. The median volumes of HES administered were 49 and 33 ml/kg in the HES 130/0.4 and HES 200/0.5 groups, respectively (P < 0.001). Consequently, patients in the HES 130/0.4 group required less gelatin in addition to HES than those in the HES 200/0.5 group (medians: 7 ml/kg vs. 20 ml/kg, P < 0.001). The combined volumes of HES and gelatin were similar for both groups (P = 0.21). The 24-h chest tube drainage (medians: 660 ml vs. 705 ml, P = 0.60) did not differ significantly between the groups, nor did transfusion outcome. CONCLUSION:Six percent HES 130/0.4 at a median dose of 49 ml/kg did not increase blood loss and transfusion requirements in coronary artery bypass surgery compared with 6% HES 200/0.5 at a median dose of 33 ml/kg.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Kasper SM,Meinert P,Kampe S,Görg C,Geisen C,Mehlhorn U,Diefenbach C

doi

10.1097/00000542-200307000-00010

subject

Has Abstract

pub_date

2003-07-01 00:00:00

pages

42-7

issue

1

eissn

0003-3022

issn

1528-1175

pii

00000542-200307000-00010

journal_volume

99

pub_type

临床试验,杂志文章,随机对照试验
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  • Lower isoflurane concentration affects spatial learning and neurodegeneration in adult mice compared with higher concentrations.

    abstract:BACKGROUND:Volatile anesthetics such as isoflurane are widely used in clinical and research contexts. Concerns have been raised that the effects of these drugs on the central nervous system may result in long-term impairment after surgery or general anesthesia. Hence, this study aimed to detect how different isoflurane...

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    authors: Valentim AM,Di Giminiani P,Ribeiro PO,Rodrigues P,Olsson IA,Antunes LM

    更新日期:2010-11-01 00:00:00

  • Vomiting and recovery after outpatient tonsillectomy and adenoidectomy in children. Comparison of four anesthetic techniques using nitrous oxide with halothane or propofol.

    abstract:BACKGROUND:The authors' purpose in this study was to compare prospectively four different anesthetic induction and maintenance techniques using nitrous oxide with halothane and/or propofol for vomiting and recovery after outpatient tonsillectomy and adenoidectomy procedures in children. METHODS:Eighty unpremedicated c...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

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    authors: Ved SA,Walden TL,Montana J,Lea DE,Tefft MC,Kataria BK,Pudimat MA,Nicodemus HF,Milmoe GJ

    更新日期:1996-07-01 00:00:00

  • Predicting difficult intubation with indirect laryngoscopy.

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    journal_title:Anesthesiology

    pub_type: 杂志文章

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    authors: Yamamoto K,Tsubokawa T,Shibata K,Ohmura S,Nitta S,Kobayashi T

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  • Dextrose affects gravitational spread of epidural anesthesia.

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    pub_type: 杂志文章

    doi:10.1097/00000542-198005000-00014

    authors: Park YR,Eastwood DW

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  • Enhancement by propofol of the gamma-aminobutyric acidA response in dissociated hippocampal pyramidal neurons of the rat.

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    pub_type: 杂志文章

    doi:10.1097/00000542-199410000-00026

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  • Prospective external validation of a predictive score for postoperative pulmonary complications.

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    pub_type: 杂志文章,多中心研究

    doi:10.1097/ALN.0000000000000334

    authors: Mazo V,Sabaté S,Canet J,Gallart L,de Abreu MG,Belda J,Langeron O,Hoeft A,Pelosi P

    更新日期:2014-08-01 00:00:00

  • Pulmonary shunt and cardiovascular responses to CPAP during nitroprusside-induced hypotension.

    abstract::The effects of continuous positive airway pressure (CPAP) on cardiovascular dynamics and pulmonary shunt (QS/QT) were investigated in 12 dogs before and during sodium nitroprusside infusion that decreased mean arterial blood pressure 40-50 per cent. Before nitroprusside infusion, 5 cm H2O CPAP significantly, P less th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197705000-00008

    authors: Hodges MR,Stanley TH,Johansen RK

    更新日期:1977-05-01 00:00:00

  • Maximum tolerated dose of nalmefene in patients receiving epidural fentanyl and dilute bupivacaine for postoperative analgesia.

    abstract:BACKGROUND:This study investigated the ability of the modified continual reassessment method (MCRM) to determine the maximum tolerated dose of the opioid antagonist nalmefene, which does not reverse analgesia in an acceptable number of postoperative patients receiving epidural fentanyl in 0.075% bupivacaine. METHODS:I...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

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    更新日期:2000-04-01 00:00:00

  • Changes in electroencephalogram and autonomic cardiovascular activity during induction of anesthesia with sevoflurane compared with halothane in children.

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    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199912000-00010

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    更新日期:1999-12-01 00:00:00

  • Double-blind, randomized comparison of ondansetron and intraoperative propofol to prevent postoperative nausea and vomiting.

    abstract:BACKGROUND:Breast surgery is associated with a high incidence of postoperative nausea and vomiting. Propofol and prophylactic administration of ondansetron are associated with a lower incidence of postoperative nausea and vomiting. To date no comparison of these two drugs has been reported. A randomized study was done ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199611000-00011

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    更新日期:1996-11-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318273349d

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  • Comparison of 0.5% ropivacaine and 0.5% bupivacaine for epidural anesthesia in patients undergoing lower-extremity surgery.

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    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199004000-00010

    authors: Brown DL,Carpenter RL,Thompson GE

    更新日期:1990-04-01 00:00:00

  • A pharmacokinetic explanation for increasing recovery time following larger or repeated doses of nondepolarizing muscle relaxants.

    abstract::The authors used pharmacokinetic and pharmacodynamic modeling to explain the time course of neuromuscular blockade following single or multiple doses of three nondepolarizing muscle relaxants. Published and unpublished pharmacokinetic and pharmacodynamic data for 13 normal subjects were used to simulate the duration o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:

    authors: Fisher DM,Rosen JI

    更新日期:1986-09-01 00:00:00

  • Acute surgical anemia influences the cardioprotective effects of beta-blockade: a single-center, propensity-matched cohort study.

    abstract:BACKGROUND:Despite decreasing cardiac events, perioperative beta-blockade also increases perioperative stroke and mortality. Major bleeding and/or hypotension are independently associated with these outcomes. To investigate the hypothesis that beta-blockade limits the cardiac reserve to compensate for acute surgical an...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181c5dd81

    authors: Beattie WS,Wijeysundera DN,Karkouti K,McCluskey S,Tait G,Mitsakakis N,Hare GM

    更新日期:2010-01-01 00:00:00

  • Inhibitory effect of lidocaine on cultured porcine aortic endothelial cell-dependent antiaggregation of platelets.

    abstract:BACKGROUND:Vascular spasm is a well-known complication during vascular surgery. Topical lidocaine is frequently used to prevent this spasm. However, the effects of lidocaine on the endothelium-dependent antiaggregation are not clear. METHODS:The aggregation of platelet-rich plasma (PRP) obtained from healthy volunteer...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199508000-00018

    authors: Az-ma T,Hardian,Yuge O

    更新日期:1995-08-01 00:00:00

  • Involvement of cerulospinal glutamatergic neurotransmission in fentanyl-induced muscular rigidity in the rat.

    abstract:BACKGROUND:Investigators in the authors' laboratory previously established the critical participation of the cerulospinal noradrenergic pathway in muscular rigidity elicited by fentanyl. The identification of colocalization of glutamate with tyrosine hydroxylase in most locus ceruleus neurons suggests a role for cerulo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199712000-00024

    authors: Fu MJ,Tsen LY,Lee TY,Lui PW,Chan SH

    更新日期:1997-12-01 00:00:00

  • Amitriptyline for prolonged cutaneous analgesia in the rat.

    abstract:BACKGROUND:Amitriptyline has been reported to be a more potent local anesthetic than bupivacaine. In keeping with the objective of identifying drugs for prolonged cutaneous analgesia, the authors compared the cutaneous analgesic effectiveness of amitriptyline and bupivacaine in rats. METHODS:Rats were subcutaneously i...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200201000-00023

    authors: Khan MA,Gerner P,Kuo Wang G

    更新日期:2002-01-01 00:00:00

  • The "educated hand". Can anesthesiologists assess changes in neonatal pulmonary compliance manually?

    abstract::To determine whether anesthesiologists can manually detect significant changes in pulmonary compliance in neonates using an "educated hand," the authors tested whether clinicians could detect clamping of an endotracheal tube connecting a neonatal lung model to one of three anesthesia breathing circuits. The test lungs...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199110000-00022

    authors: Spears RS Jr,Yeh A,Fisher DM,Zwass MS

    更新日期:1991-10-01 00:00:00

  • Growth cone collapsing effect of lidocaine on DRG neurons is partially reversed by several neurotrophic factors.

    abstract:BACKGROUND:Local anesthetics were suggested to have a potential for neurotoxicity in both clinical reports and laboratory experiments. Growing neurons have been shown to be susceptible to the toxic effects of local anesthetics in culture. These findings have generated the interest in factors that would rescue the neuro...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200209000-00017

    authors: Radwan IA,Saito S,Goto F

    更新日期:2002-09-01 00:00:00

  • Association of ethnicity with the minimum alveolar concentration of sevoflurane.

    abstract:BACKGROUND:Selective breeding produces animal strains with varying anesthetic sensitivity. It thus seems unlikely that various human ethnicities have identical anesthetic requirements. Therefore, the authors tested the hypothesis that the minimum alveolar concentration of sevoflurane differs significantly as a function...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.anes.0000267534.31668.62

    authors: Ezri T,Sessler D,Weisenberg M,Muzikant G,Protianov M,Mascha E,Evron S

    更新日期:2007-07-01 00:00:00

  • Nitrous oxide diffusion and the second gas effect on emergence from anesthesia.

    abstract:BACKGROUND:Rapid elimination of nitrous oxide from the lungs at the end of inhalational anesthesia dilutes alveolar oxygen, producing "diffusion hypoxia." A similar dilutional effect on accompanying volatile anesthetic agent has not been evaluated and may impact the speed of emergence. METHODS:Twenty patients undergoi...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0b013e318209367b

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    更新日期:2011-03-01 00:00:00

  • Patient blood management in elective total hip- and knee-replacement surgery (Part 1): a randomized controlled trial on erythropoietin and blood salvage as transfusion alternatives using a restrictive transfusion policy in erythropoietin-eligible patients

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    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/ALN.0000000000000134

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    更新日期:2014-04-01 00:00:00

  • Nitrogen analyzer adaptation for use in the presence of halogenated anesthetics.

    abstract::Interposition of activated carbon between a nitrogen analyzer needle valve and gas mixtures containing halothane, methoxyflurane, enflurane, or isoflurane eliminated the interfering effects of these agents, but added sampling delays. Placement of a carbon-filled Swinney adaptor in the sampling line between the needle ...

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    pub_type: 杂志文章

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    authors: Gilmour IJ,Holland R,Craig DB

    更新日期:1975-12-01 00:00:00

  • Interaction between sedative premedicants and ketamine in man in isolated perfused rat livers.

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    pub_type: 杂志文章

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    authors: Lo JN,Cumming JF

    更新日期:1975-09-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00000542-199204000-00010

    authors: Adnet PJ,Krivosic-Horber RM,Adamantidis MM,Haudecoeur G,Reyford H,Imbenotte M

    更新日期:1992-04-01 00:00:00

  • Cardiopulmonary resuscitation: effect of CPAP on gas exchange during chest compressions.

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    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199904000-00022

    authors: Hevesi ZG,Thrush DN,Downs JB,Smith RA

    更新日期:1999-04-01 00:00:00

  • Propofol: the challenges of formulation.

    abstract::Propofol is a potent lipophilic anesthetic that was initially formulated in Cremophor El for human use. Because of the occurrence of Cremophor EL anaphylaxis and improvements in the quality of lipid emulsions, it was ultimately brought to market as 1% propofol formulated in 10% soybean oil emulsion. Emulsions represen...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/00000542-200510000-00026

    authors: Baker MT,Naguib M

    更新日期:2005-10-01 00:00:00

  • Sympathetic responses to induction of anesthesia in humans with propofol or etomidate.

    abstract::Anesthetic induction with propofol commonly results in hypotension. This study explored potential mechanisms contributing to hypotension by recording cardiovascular responses including sympathetic neural activity from patients during induction of anesthesia with propofol (2.5 mg.kg-1 plus 200 micrograms.kg-1.min-1) or...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199205000-00010

    authors: Ebert TJ,Muzi M,Berens R,Goff D,Kampine JP

    更新日期:1992-05-01 00:00:00