在接受离体开放式心脏瓣膜手术的患者中,将6%羟乙基淀粉130/0.4和林格乳酸盐作为引流液进行比较:双盲随机对照试验。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Perfusion-Uk Pub Date : 2025-01-01 Epub Date: 2023-12-17 DOI:10.1177/02676591231222135
Behzad Sheikhi, Yousef Rezaei, Farnaz Baghaei Vaji, Mostafa Fatahi, Mehdi Hosseini Yazdi, Ziae Totonchi, Sepideh Banar, Mohammad Mehdi Peighambari, Saeid Hosseini, Carlos-A Mestres
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引用次数: 0

摘要

目的:在心肺旁路(CPB)泵的启动液中加入胶体以维持胶体渗透压并防止液体超负荷。本研究旨在比较 6% 羟乙基淀粉(HES)130/0.4 和林格乳酸盐(RL)引流液对使用 CPB 进行离体心脏瓣膜手术的患者预后的影响:这项随机临床试验纳入了 120 名接受心脏瓣膜手术的患者,并将其分为两组。RL 组患者接受 1500 毫升 RL,RL + HES 组患者接受 500 毫升 HES 和 1000 毫升 RL:RL + HES 组和 RL 组患者的中位年龄分别为 52(IQR 42-60)岁和 50(IQR 40-61)岁(p = .71)。与 RL 组相比,RL + HES 组在手术室和重症监护室需要输血的病例数也明显高于 RL 组(RR 2.04,95% CI 1.50-2.76; p < .01 和 RR 1.42,95% CI 1.01-2.01; p = .05)。与RL组相比,RL + HES组的术后肌酐水平和血小板计数下降幅度更大(受试者间效应分别为p = .007和p = .038),而急性肾损伤的发生率在两组之间不相上下(RR 0.66,95% CI 0.13-3.30;p = .55):结论:在使用 CPB 进行心脏瓣膜手术的患者中,与仅使用 RL 相比,在 RL 中加入 6% 的 HES 作为起始剂量会增加住院期间需要输注血制品的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of six percent hydroxyethyl starch 130/0.4 and ringer's lactate as priming solutions in patients undergoing isolated open heart valve surgery: A double-blind randomized controlled trial.

Objectives: Colloids are added to the priming solution of the cardiopulmonary bypass (CPB) pump to maintain colloid osmotic pressure and prevent fluid overload. This study aimed to compare the effects of 6% hydroxyethyl starch (HES) 130/0.4 and ringer's lactate (RL) priming solution on patients' outcomes undergoing isolated heart valve surgery with CPB.

Methods: This randomized clinical trial included one hundred and 20 patients undergoing heart valve surgery, and those were allocated into two groups. Patients in the RL group received 1500 mL of RL, and those in the RL + HES group were given 500 mL of HES and 1000 mL of RL.

Results: The patients' median age was 52 (IQR 42-60) and 50 (IQR 40-61) years in the RL + HES and the RL group, respectively (p = .71). The number of cases that required blood product transfusion in both the operating room and intensive care unit was also significantly higher in the RL + HES group compared to the RL group (RR 2.04, 95% CI 1.50-2.76; p < .01 and RR 1.42, 95% CI 1.01-2.01; p = .05, respectively). Declines in postoperative creatinine levels and platelet counts were higher in the RL + HES compared to the RL group (between-subjects effect p = .007 and p = .038, respectively), while the incidence of acute kidney injury was comparable between groups (RR 0.66, 95% CI 0.13-3.30; p = .55).

Conclusions: Among patients undergoing heart valve surgery with CPB, 6% HES added to RL for priming compared with only RL increased the risk of the need for blood product transfusion over the hospitalization period.

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来源期刊
Perfusion-Uk
Perfusion-Uk 医学-外周血管病
CiteScore
3.00
自引率
8.30%
发文量
203
审稿时长
6-12 weeks
期刊介绍: Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.
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