CLINICAL AND HAEMODINAMIC EFFECT OF HYDROXYETHIL STARCH SOLUTIONS IN CHILDREN SEPTIC SHOCK

Veliz PR, Garcia GE, Torres VA, Caballero VC, Marquez M, Aguilar V

La Raza General Hospital IMSS, Mexico D.F. Mexico

 

Objective: Know the clinical and hemodinamic effect of the early administration of Hydroxyethil Starch (HAES) in septic pediatric patient, compared with the effect of the same solution in late septic shock and with patients who received albumin or dextran 40.

Methods: 69 patients were studied, 8 groups were formed,(1) 15 patients with early hypodinamic shock managed with HAES, (2)12 early HAES hyperdinamic shock,(3) 5 patients with late Other Colloid (OC) volume replacement early hyperdinamic shock,(4) 9 OC early Hypodinamic shock; (5)7 OC Late Hypodinamic shock,(6) 7 OC Late Hyperdinamic shock,(7) 7 HAES late Hyperdinamic shock,(8) 7 HAES Late Hypodinamic shock. All of them were measured and compared with themselves al 0,1and 6 hrs..student t test for independent samples and pared samples as well as variance one way analysis were used.

Result: Oxygen a/v difference (O2a/vDif). in group 1 diminished to normal with p<0.01, group 2, increased O2a/vdif. to normal wit p<0.01, group 3 increased O2a/vdif with p<0.05 not reaching normal levels, group 4 showed no statistical difference in three measurements, Group 5: Showed no statistical difference in three measurements.Group 6: Increased O2a/vdif. To normal levels but no statistical difference were found. Group 7 increased O2a/vdif. To normal levels with p<0.05. Group 8: diminished O2a/vDif. With p<0.05. Other than O2a/vDif, we measured and compared, Heart rate, Capillary refill, Mead arterial Tension, Mix venous oxygen content, arterial pH, CVP, CI, Swan Ganz catheter measurements. And mortality. Conclusion: Early shock management improved better and had less mortality than late shock management, HAES improved better and had less mortality than other colloid in early shock.

 
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