Effects of an intraoperative infusion of 4% succinylated gelatine (Gelofusine®) and 6% hydroxyethyl starch (Voluven®) on blood volume

This study aims to study changes in blood volume after 1 litre infusions of Gelofusine [4 succinylated gelatine in 0.7 saline, weight-average molecular weight (MWw) 30 kDa] and Voluven (6 hydroxyethyl starch in 0.9 saline, MWw 130 kDa) in the presence of increased capillary permeability. In this randomized double-blind study, adults undergoing laparoscopic cholecystectomy received 1 litre of Gelofusine (n12) or Voluven (n13) over 1 h at the induction of anaesthesia. No other fluids were given. Haematocrit, serum electrolytes, and osmolality were measured before infusion and hourly thereafter for 4 h. Changes in blood volume were calculated from changes in haematocrit. The urinary albumin:creatinine ratio (ACR) was measured before and after operation. Baseline parameters before the two infusions were similar (P0.050). The urinary ACR increased significantly after operation after Gelofusine (P0.011) and Voluven (P0.002), indicating increased capillary permeability. Voluven produced a greater increase in serum chloride concentration (P0.028) and a larger decrease in strong ion difference (P0.009) than Gelofusine. There were no significant differences in changes in haematocrit (P0.523) and blood volume (P0.404) over the study period when the two infusions were compared, nor were there any differences in serum sodium, potassium, bicarbonate, and albumin concentrations (P0.050). Urine output, sodium concentration, and osmolality were similar after the two infusions (P0.050). The blood volume-expanding effects of the two colloids were not significantly different, despite the increase in postoperative urinary ACR and the 100 kDa difference in MWw.