Hydroxyethyl starch versus lactated Ringer's solution in the chronic maternal-fetal sheep preparation: a pharmacodynamic and pharmacokinetic study

Anesthesia and Analgesia
M A MarcusH Van Aken

Abstract

Administration of fluids intravenously prior to spinal and epidural analgesia in obstetrics is required to prevent maternal hypotension and fetal hypoxia. A colloid solution, such as hydroxyethyl starch (HES), might be preferable considering the capacity to stay intravascularly for a longer period. In this study the placental transfer of HES and the hemodynamic effects after infusion were investigated using a chronic maternal-fetal sheep preparation. Either 500 mL HES 10% or 750 mL lactated Ringer's solution (RL) was infused intravenously into the ewe over 30 min. Fetal and maternal blood were assayed for HES, blood gases, and acid-base status before and at regular intervals after infusion. Maternal and fetal cardiovascular variables were recorded continuously for 90 min. After HES infusion, maternal HES levels peaked at 30 min ranging from 6.9 mg/mL to 12.1 mg/mL and declined at 24 h to levels between 0.3 mg/mL and 2.8 mg/mL. Mean fetal HES concentrations remained below 0.3 mg/mL. Infusion of HES decreased hemoglobin (Hb) and plasma viscosity (PV) in the mother. Infusion of RL decreased Hb, but did not change PV. Infusion of HES significantly increased uterine blood flow (UBF), cardiac output (CO), total oxygen-delivery capaci...Continue Reading

References

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Citations

Aug 10, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·S M SiddikA S Baraka
Aug 10, 2000·Anesthesiology Clinics of North America·M G Richardson
Oct 8, 2003·Best Practice & Research. Clinical Anaesthesiology·Wiebke Gogarten
Sep 1, 2013·Anesthesia, Essays and Researches·Rohit Varshney, Gaurav Jain
Jun 10, 2008·Cardiovascular Research·Francesco Fazi, Clara Nervi
Jul 18, 2008·Human Molecular Genetics·Victoria V Lunyak, Michael G Rosenfeld
Oct 6, 2006·Current Opinion in Anaesthesiology·Wiebke Gogarten
May 28, 2005·European Journal of Anaesthesiology·W GogartenM A E Marcus
Oct 4, 2006·Current Opinion in Anaesthesiology·M A Marcus, H Van Aken

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