Véliz PR, Torres VA, García GER, Andrade PM, Toledo VAD, Pérez PH , Martínez RMT, Paniagua MME, Millán C, Estrada CM, López MG, Urban H, Peguero PL, Orózco BO, Robles J, Balam CVY, Marquez M, Aguilar ZV, Caballero C, Risco CR, Carrillo H, Chávez A, López SL, Correa M, Montufar R, Bonilla AR, García LLR

Language: Spanish
References: 43
Page: 93-106
PDF size: 195.88 Kb.

ABSTRACT

This is a preliminary report of a multicentric clinical research. The purpose of the study is to measure, the clinical and hemodinamic response to the IV infusion of hydroxyethyl-Starch, HAES (Fresenius), as a plasma expander, in children with shock and a low preload.
The study was done in 15 pediatric patients, from one month age to 14 years old; 70% of them were female. There was 10 cases with hypodinamic shock (group I) according to short oxigen arteriovenous difference, and five cases (group II) have hiperdinamic shock according to a large O₂ a/v difference. In each patient the next measurements were done: heart rate (HR) mean arterial blood pressure (MABP), central venous pressure (CVP), capillary refill, oxigen a/v difference, oxigen extraction percent (O₂E%), venous oxigen content (vO₂c), and arterial pH. Measurements were compared pre vs. post HAES administration.
Four patients were hemodinamically studied and controlled, during the event of shock with a Swan-Ganz catheter, they are shown separetly as single cases.
Group I showed statistically significant difference between the initial and after HES IV administration, in: O₂a/v difference, MABP, CVP, Capillary Refilling, O₂E%, vO₂C; all of them tend to normal ranks. Group II, showed statistical significant difference between the initial and after administration of hydroxyethyl starch, in: HR, CVP, O₂E%; the rest of the variable tend to normal, without statistical difference. Of the four cases with hemodynamic measurements which are shown separately, three of them had an hyperdinamic behavior with elevated CI, all the measurements tend to normal levels, one case had a hypodinamic behavior and never responded to the treatment.
Conclusions. All the direct or indirect hemodinamic parameters tended to normal levels in group I and II except in one case. Results so far are encouraging. The study is intended to be with a bigger sample and with a control group.

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