Effect of NaCl/Hydroxyethyl Starch 200/0.5 on Lung Function and Hemodynamics in Patients Operated on under Extracorporeal Circulation

• Main Authors: V. V. Lomivorotov, E. V. Fominsky, V. A. Nepomnyashchikh, S. M, Efremov, A. M. Chernyavsky, V. N. Lomivorotov, A. N. Shilova, A. M. Karaskov
• Format: Article
• Language: Russian
• Published: Russian Academy of Medical Sciences 2012-10-01
• Series: Obŝaâ Reanimatologiâ
• Online Access: https://www.reanimatology.com/rmt/article/view/198

Objective: to study the effect of 7.2% NaCl/hydroxyethyl starch 200/0.5 on extravascular lung water and respiratory and cardiovascular systems in patients with coronary heart disease (CHD) after myocardial revascularization under extracorporeal circulation (EC). Subjects and methods. A prospective, randomized study was conducted in 40 patients with coronary artery disease. A study group (n=20) received 7.2% NaCl/hydroxyethyl starch 200/0.5; a control group (n=20) had 0.9% NaCl in a dose of 4 ml/kg within 30 min before EC. Extravascular lung water and central hemodynamic parameters were assessed using transpulmonary thermodilution and a Swan-Ganz catheter; respiratory function was estimated by the arterial oxygenation index, alveolar-arterial oxygen tension difference, and venous shunt fraction. Plasma osmolality and Na concentration were determined using an Osmomat 030 device. Conclusion. The intraoperative use of 7.2% NaCl/hydroxyethyl starch 200/0.5 in patients with CHD leads to a significant reduction in extravascular lung water after myocardial revascularization, thereby effectively protecting pulmonary oxygenizing function. The single administration of 7.2% NaCl/hydroxyethyl starch causes a short-term increase in cardiac index and it is a relatively safe in preventing neurological disorders and heart failure. Key words: 7.2% NaCl/hydroxyethyl starch 200/0.5; extravascular lung water, respiratory function, cardiac index, osmolarity.