Comparison of the effect of 6% hydroxyethyl starch and gelatine on cardiac and stroke volume index: a randomized, controlled trial after cardiac surgery

Background and aims: The objective of this study was to find out the effect of various doses of hydroxyethyl starch (HES), gelatine or Ringer's acetate on cardiac and stroke volume index after cardiac surgery. Material and methods: Three consecutive boluses (each 7 mL.kg(-1)) of either 6% HES 130/0.4, 4% gelatine, or Ringer's acetate solutions were administered to 45 patients postoperatively. The rate of infusions was adjusted according to haemodynamic measurements. Thereafter, infusion of the study solution (7 mL.kg(-1)) was continued for the following 12 hours. The total dose of study solution was 28 mL.kg(-1). Results and conclusion: Mean (SD) cardiac and stroke volume indices were greater in the HES group [2.8 L.min(-1). m(-2) (0.7), 34.1 (6.7) ml.m(-2)] than in the gelatine group [2.2 L.min(-1.)m(-2) (0.6), 25.8 (7.2) ml.m(-2)] after completion of 7 mL. kg(-1) of study solution. At this stage, the effect of gelatine did not differ from Ringer's acetate. After completion of 14 mL.kg(-1) and 21 mL.kg(-1) of colloids, similar cardiac and stroke volume indices were observed and the haemodynamic response was better in both colloid groups than in the Ringer's acetate group. No differences between groups were detected on the first postoperative morning. In the early postoperative phase after cardiac surgery, the effect of a single dose of HES solution on the haemodynamics was superior to the effect of gelatine or Ringer's acetate. However, after repeated administration of the study solutions, the haemodynamics in the two colloid groups appeared to be similar, but superior to the Ringer's acetate group.