Splanchnic oxygenation in patients undergoing abdominal aortic aneurysm repair and volume expansion with eloHAES
Section snippets
Patients and methods
Informed consent was obtained from 22 consecutive patients scheduled for elective aneurysm surgery. Patients were randomised to receive either hydroxyethyl starch (eloHAES) (Fresinius, UK) or gelofusine as colloid during surgery and postoperatively. Tissue oxygenation was monitored indirectly by measuring pHi using a nasogastric tonometer (TRIP® tonometry catheter, Datex, Helsinki, Finland). All study patients received 300 mg of ranitidine orally eight hours before surgery to improve the
Results
Randomisation resulted in two groups of patients who were matched for age and sex. The duration of the operation and the aortic cross clamp times were comparable in the two groups of patient studied (Table 1). Patients treated with gelofusine required a significantly larger volume of colloid to maintain the central venous pressure and mean arterial pressure postoperatively (4065±269 ml in the gelofusine group vs 3175±175 ml in the eloHAES group, P=0.01). The requirements for crystalloid was
Discussion
This study demonstrates a clear relationship between the choice of colloid for plasma expansion during aortic aneurysm surgery and splanchnic perfusion as determined by gastric pHi. Patients resuscitated with hydroxyethyl starch required significantly less colloid and were able to maintain splanchnic perfusion to a greater extent than patients resuscitated with gelofusine. Marik et al. showed that patients resuscitated with hydroxyethyl starch during elective aortic aneurysm repair required
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