The new hydroxyethyl starch,voluven(HES130/0.4),through optimization of substitutional level and molecular weight distribution,not only has good pharmacological characteristics such as broader clinical applications,hi...The new hydroxyethyl starch,voluven(HES130/0.4),through optimization of substitutional level and molecular weight distribution,not only has good pharmacological characteristics such as broader clinical applications,higher safety and fewer side effects,but also has the feature in some aspects just like micro-circulation and the supply of oxygen in tissue.So it makes promising prospects in clinical management of volume.This article summarized the security,the side effects,the unique pharmacological characteristics and clinical applications of voluven as well as liquid treatment.展开更多
Background The optimal colloid for use during kidney transplantation is not clear. Patients undergoing living-related kidney transplantation （LRKT） were used to compare the protective effects of 6% hydroxyethyl star...Background The optimal colloid for use during kidney transplantation is not clear. Patients undergoing living-related kidney transplantation （LRKT） were used to compare the protective effects of 6% hydroxyethyl starch 130/0.4 （HES 130/0.4） and 4% succinylated gelatine, as donor kidney procurement, ischemia time and surgical conditions are comparable. Stroke volume variation （SVV） was used to monitor intravascular volume to avoid renal allograft hypoperfusion.Methods Eighty patients undergoing LRKT were divided into two groups： group H received 6% HES 130/0.4 and group G received 4% succinylated gelatine. All donors and recipients received 15-25 ml/kg of the relevant colloid during surgery. Arterial blood pressure （ABP）, heart rate （HR）, central venous pressure （CVP）, SVV and cardiac index （CI）,electrocardiography （ECG） and SpO2 were monitored continuously. SVV was kept between 6%-13% and mean arterial pressure at 100-130 mmHg. Samples of venous blood and urine were obtained 30 minutes after unclamping and on the mornings of post-operative days （POD） 1-4 to measure serum and urine β2-microglobulin, urine α1-microglobulin,microalbumin and N-acetyl-β-D-glucosaminidase. Blood urea nitrogen （BUN） and creatine were determined pre-operation （to）, 3 hours after surgery （t1） and on PODs 1 （t2）, 2 （t3）, 4 （t4）, 7 （t5） and 10 （t6）. Urine output was recorded at t1, t2, t5, t6.Results Age, body weight, body surface area （BSA）, operation time, urine output and the colloid volume infused were comparable between the groups and hemodynamics were stable during surgery. BUN, serum creatine, serum β2-microglobulin and urine β2-microglobulin decreased significantly after surgery in both groups relative to the baseline.BUN decreased significantly in group H compared with group G at t1, t2 and t4. Urine microalbumin decreased significantly in group H on POD 4 compared with group G. Urine α1-microglobulin was not significantly different between the two group展开更多
Background There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury. Me...Background There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury. Methods Totally, 18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia. Resuscitation therapy was applied 2 hours after the injury, using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of bums. The Ba-Ma mini-pigs were randomly assigned to three groups （six pigs in each group）： succinylated gelatin group （the artificial colloid used was succinylated gelatin Injection）, hydroxyethyl starch group （the artificial colloid used was hydroxyethyl starch （130/0.4））, and allogeneic plasma group （the colloid used was allogeneic plasma）. Blood samples were collected from the animals prior to the bum injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The platelet count （PLT）, prothrombin time （PT）, international normalized ratio （INR）, activated partial thromboplastin time （APTT）, and fibrinogen （Fib） were measured, followed by a statistical analysis of all results. Results The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were （124.3±52.7）, （78.8±16.4）×10^9/L and （159.0±62.8）, （87.3±32.0）×10^9/L respectively. But in the allogeneic plasma group at intervals of 8, 24, and 48 hours were （234.3±52.6）, （136.0±47.4）, （75.8±31.0）×10^9/L. The decrease were all statistically significant （P 〈0.05, P 〈0.01） when compared to pre-burn （（383.3±77.9）, （382.7±65.7）, （381.0±49.4）×10^9/L）. The PLT among the three groups, at all the time points, had no statistical difference （P 〉0.05）. Compared to pre-burn （（10.8±0.9）, （11.4± 0.8）, （10.6±0.7） seconds）, the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were （14.展开更多
文摘The new hydroxyethyl starch,voluven(HES130/0.4),through optimization of substitutional level and molecular weight distribution,not only has good pharmacological characteristics such as broader clinical applications,higher safety and fewer side effects,but also has the feature in some aspects just like micro-circulation and the supply of oxygen in tissue.So it makes promising prospects in clinical management of volume.This article summarized the security,the side effects,the unique pharmacological characteristics and clinical applications of voluven as well as liquid treatment.
文摘Background The optimal colloid for use during kidney transplantation is not clear. Patients undergoing living-related kidney transplantation （LRKT） were used to compare the protective effects of 6% hydroxyethyl starch 130/0.4 （HES 130/0.4） and 4% succinylated gelatine, as donor kidney procurement, ischemia time and surgical conditions are comparable. Stroke volume variation （SVV） was used to monitor intravascular volume to avoid renal allograft hypoperfusion.Methods Eighty patients undergoing LRKT were divided into two groups： group H received 6% HES 130/0.4 and group G received 4% succinylated gelatine. All donors and recipients received 15-25 ml/kg of the relevant colloid during surgery. Arterial blood pressure （ABP）, heart rate （HR）, central venous pressure （CVP）, SVV and cardiac index （CI）,electrocardiography （ECG） and SpO2 were monitored continuously. SVV was kept between 6%-13% and mean arterial pressure at 100-130 mmHg. Samples of venous blood and urine were obtained 30 minutes after unclamping and on the mornings of post-operative days （POD） 1-4 to measure serum and urine β2-microglobulin, urine α1-microglobulin,microalbumin and N-acetyl-β-D-glucosaminidase. Blood urea nitrogen （BUN） and creatine were determined pre-operation （to）, 3 hours after surgery （t1） and on PODs 1 （t2）, 2 （t3）, 4 （t4）, 7 （t5） and 10 （t6）. Urine output was recorded at t1, t2, t5, t6.Results Age, body weight, body surface area （BSA）, operation time, urine output and the colloid volume infused were comparable between the groups and hemodynamics were stable during surgery. BUN, serum creatine, serum β2-microglobulin and urine β2-microglobulin decreased significantly after surgery in both groups relative to the baseline.BUN decreased significantly in group H compared with group G at t1, t2 and t4. Urine microalbumin decreased significantly in group H on POD 4 compared with group G. Urine α1-microglobulin was not significantly different between the two group
文摘Background There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury. Methods Totally, 18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia. Resuscitation therapy was applied 2 hours after the injury, using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of bums. The Ba-Ma mini-pigs were randomly assigned to three groups （six pigs in each group）： succinylated gelatin group （the artificial colloid used was succinylated gelatin Injection）, hydroxyethyl starch group （the artificial colloid used was hydroxyethyl starch （130/0.4））, and allogeneic plasma group （the colloid used was allogeneic plasma）. Blood samples were collected from the animals prior to the bum injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The platelet count （PLT）, prothrombin time （PT）, international normalized ratio （INR）, activated partial thromboplastin time （APTT）, and fibrinogen （Fib） were measured, followed by a statistical analysis of all results. Results The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were （124.3±52.7）, （78.8±16.4）×10^9/L and （159.0±62.8）, （87.3±32.0）×10^9/L respectively. But in the allogeneic plasma group at intervals of 8, 24, and 48 hours were （234.3±52.6）, （136.0±47.4）, （75.8±31.0）×10^9/L. The decrease were all statistically significant （P 〈0.05, P 〈0.01） when compared to pre-burn （（383.3±77.9）, （382.7±65.7）, （381.0±49.4）×10^9/L）. The PLT among the three groups, at all the time points, had no statistical difference （P 〉0.05）. Compared to pre-burn （（10.8±0.9）, （11.4± 0.8）, （10.6±0.7） seconds）, the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were （14.
