Acute hypervolemic hemodilution with hydroxyethyl starch 130/0.4-electrolyte injection versus hydroxyethyl starch 130/0.4-sodium chloride injection for blood-saving effect

Objective To compare the blood-saving effect when acute hypervolemic hemodilution (AHH) was performed with hydroxyethyl starch (HES) 130/0.4 dissolved in electrolyte injection (HES-E) and HES 130/0.4 in sodium chloride injection (HES-NaCl). Methods Thirty patients of both sexes, aged 18-60 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, with body mass index of 18-25 kg/m2, hemoglobin (Hb)>100 g/L, hematocrit (Hct)> 35%, scheduled for elective abdominal operations under general anesthesia, were randomly divided into HES-E group and HES-NaCl group using a random number table, with 15 patients in each group.AHH was performed after induction of anesthesia.In HES-E and HES-NaCl groups, HES-E and HES-NaCl 15 ml/kg were intravenously infused over 30 min, respectively, and the infusion was completed before skin incision.Immediately after onset of AHH (T1), at 2 h after the end of AHH (T2), and at the end of operation (T3), arterial blood samples were collected for blood gas analysis and blood routine test, and pH value, base excess, HCO3-, K+ , Na+ , Cl-, Ca2+ , Hb and Hct were recorded.Venous blood samples were collected at T1 and T2 for measurement of blood coagulation parameters including prothrombin time, activated partial thromboplastin time and fibrinogen and thrombelastography parameters.The volume of liquid intake and output and requirement for allogeneic blood transfusion were recorded, and the blood volume expansion rate was calculated. Results Compared with group HES-NaCl, no significant changes were found in the total volume of liquid infused, requirement for allogeneic blood transfusion, blood volume expansion rate, blood coagulation parameters at each time point, Hb and Hct (P>0.05), pH value, base excess, HCO3- and K+ were significantly increased, and Na+ and Cl-were significantly decreased in group HES-E (P<0.01). Conclusion There is no significant difference in the blood-saving effect between AHH with HES-E and HES-NaCl clinically, but HES-E can maintain homeostasis better. Key words: Hetastarch; Hemodilution