Korean J Anesthesiol.  2018 Dec;71(6):459-466. 10.4097/kja.d.18.27195.

Acid/base alterations during major abdominal surgery: 6% hydroxyethyl starch infusion versus 5% albumin

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon, Korea. endless37@gilhospital.com
  • 2Department of Rehabilitation Medicine, Gachon University Gil Medical Center, Incheon, Korea.

Abstract

BACKGROUND
To compare the effects of intraoperative infusions of balanced electrolyte solution (BES)-based hydroxyethyl starch (HES) and saline-based albumin on metabolic acidosis and acid/base changes during major abdominal surgery conducted using Stewart's approach.
METHODS
Forty patients, aged 20-65 years, undergoing major abdominal surgery, were randomly assigned to the HES group (n = 20; received 500 ml of BES-based 6% HES 130/0.4) or the albumin group (n = 20; received 500 ml of normal saline-based 5% albumin). Acid-base parameters were measured and calculated using results obtained from arterial blood samples taken after anesthesia induction (T1), 2 hours after surgery commencement (T2), immediately after surgery (T3), and 1 hour after arriving at a postanesthetic care unit (T4).
RESULTS
Arterial pH in the HES group was significantly higher than that in the albumin group at T3 (7.40 ± 0.04 vs. 7.38 ± 0.04, P = 0.043), and pH values exhibited significant intergroup difference over time (P = 0.002). Arterial pH was significantly lower at T3 and T4 in the HES group and at T2, T3, and T4 in the albumin group than at T1. Apparent strong ion difference (SIDa) was significantly lower at T2, T3, and T4 than at T1 in both groups. Total plasma weak nonvolatile acid (ATOT) was significantly lower in the HES group than in the albumin group at T2, T3 and T4 and exhibited a significant intergroup difference over time (P < 0.001).
CONCLUSIONS
BES-based 6% HES infusion was associated with lower arterial pH values at the end of surgery than saline-based 5% albumin infusion, but neither colloid caused clinically significant metabolic acidosis (defined as an arterial pH < 7.35).

Keyword

Acid base; Albumin; Hydroxyethyl starch

MeSH Terms

Acidosis
Anesthesia
Colloids
Humans
Hydrogen-Ion Concentration
Plasma
Starch*
Colloids
Starch
Full Text Links
  • KJAE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr