高渗盐水羟乙基淀粉用于严重脓毒症行小容量液体复苏的观察

目的 观察应用7.5％高渗盐水(HS)联合6％羟乙基淀粉130/0.4(HES)对严重脓毒症患者行小容量液体复苏的有效性.方法 采用前瞻性随机对照研究.选取我院重症监护病房(ICU)严重脓毒症患者70例,随机分为两组:HS+HES组35例,输注7.5％ HS 4 ml/kg和6％ HES 130/0.4 500 ml,...

Effect of hypertonic saline and hydroxyethyl starch on small fluid resuscitation for severe sepsis

Objective To evaluate the effect of 7.5% hypertonic saline (HS) combined with 6% hydroxyethylstarch (HES) 130/0.4 on small fluid resuscitation for severe sepsis. Methods Prospective randomized control trial was carried out in intensive care unit (ICU) of the Third Hospital of Changsha. Seventy patients with severe sepsis were randomly divided into two groups, each with 35 cases. Patients in HS+HES group received 7.5% HS and 500 ml 6% HES 130/0.4 followed by lactated Ringer solution, while those in HES group received 500 ml 6% HES 130/0.4 followed by lactated Ringer solution. Mean arterial pressure (MAP), oxygenation index (PaO2/FiO2), arterial lactate (Lac), urine output and incidence of multiple organ dysfunction syndrome (MODS) were compared between the two groups at 6 hours and 24 hours after small fluid resuscitation. Results At 6 hours after fluid resuscitation, MAP, PaO2/FiO2, urine output in HS+HES group were significantly higher than those in HES group. At 24 hours after fluid resuscitation, lactate clearance rate, urine output was significantly higher in HS+HES group than HES group, and fluid infusion volume and the incidence of MODS in HS+HES group was markedly less than that in HES group. Conclusion 7.5% HS and 6% HES 130/0.4 could improve the effect of small fluid resuscitation on severe sepsis, and it could lower the incidence of MODS.