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무체외순환 관상동맥 우회술에서 6% Hydroxyethyl starch (HES) 130/0.4와 6% HES 200/0.5가 조직 산소화와 수술 후 출혈에 미치는 영향

Other Titles
 The effects of 6% Hydroxyethyl Starch (HES) 130/0.4 and 6% HES 200/0.5 on tissue oxygenation and postoperative bleeding in patients undergoing off-pump coronary artery bypass surgery 
Authors
 김창석  ;  곽영란  ;  방서욱  ;  심재광  ;  라세희  ;  김대희 
Citation
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.52(6) : 649-656, 2007 
Journal Title
 KOREAN JOURNAL OF ANESTHESIOLOGY 
ISSN
 2005-6419 
Issue Date
2007
Abstract
Background : Hydroxyethyl starch (HES) effectively restores plasma volume and thereby enhances microcirculation and tissue oxygenation at the expense of coagulation impairment. These effects are related to molecular weight, substitution and C2:C6 ratio. But, most of the studies regarding coagulation impairment in cardiac surgeries were performed in patients undergoing cardiopulmonary bypass which significantly causes coagulation derangements. Therefore, we have evaluated the effects of 2 different HES solutions on tissue oxygenation and postoperative bleeding in patients undergoing off-pump coronary artery bypass surgery (OPCAB). Methods : Forty four patients were prospectively enrolled. After the induction of anesthesia, either HES 130/0.4 (V group) or 200/0.5 (H group) were infused for fluid therapy to maintain predetermined urine output, cardiac index and filling pressure up to 16 h after the surgery. Tissue oxygenation profiles and respiratory parameters were recorded after induction of anesthesia, completion of distal anastomosis and sternum closure, upon admission at intensive care unit, and 4 h thereafter. The amounts of chest tube drainage, transfusion and fluid balance were measured up to 16 h after the surgery. Results : Patients' demographic data were similar between the groups. Tissue oxygenation profiles, respiratory parameters, hemodynamics, and time to extubate were not different between the groups. However, chest tube drainage and transfusion requirements were significantly less in the V group. Conclusions : In OPCAB, 6% HES 130/0.4 causes less postoperative bleeding and transfusion requirement and has a comparable efficacy on hemodynamic stability, pulmonary function and tissue oxygenation when compared to 6% HES 200/0.5.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Na, Se Hee(라세희) ORCID logo https://orcid.org/0000-0003-4208-0769
Bang, Sou Ouk(방서욱)
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96842
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