Effects of an intraoperative infusion of 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume.

摘要

Editor-We read with interest the article comparing 4% succi-nylated gelatine and 6% hydroxyethyl starch (HES) and its findings that 6% HES produced a statistically significant greater increase in serum chloride concentration suggesting a tendency to produce hyperchloraemic acidosis in comparison with 4% succinylated gelatine, while the blood-volume expanding effects were not significantly different.The type of colloid used in the resuscitation of critically ill patients has been debated by clinicians for many years. However, the European Society of Intensive Care Medicine (ESICM) Task Force have advised in March 2012 against the use of HES in patients with severe sepsis or risk of acute kidney injury.2 Furthermore, the Scandinavian Starch for Severe Sepsis/Septic Shock Trial (6S) has shown there to be an increased 90 day mortality and increased risk of acute kidney injury requiring renal replacement therapy with 6% HES,3 and thus, we feel together with the results of the published article, there is now strong evidence to suggest we should not be using HES in critically ill patients.