6% 130/0.4 versus 6% 200/0.5 hydroxyethyl starch: effects on plasma volume and capillary leakage in a porcine model of septic shock

Objectives

Septic shock is characterised by loss of intravascular fluid due to capillary leakage syndrome (CLS) [1]. We have recently reported that the administration of 200/0.5 hydroxyethyl starch (HES) stabilised the plasma volume (PV) in a porcine septic shock/CLS model, suggesting the intravascular persistence of artificial colloids despite CLS [2]. In the present study we compared the effects of 6% HES 130/0.4 and 6% HES 200/0.5 on PV and CLS in porcine septic shock.

Methods

In a prospective randomized, controlled laboratory study, 14 fasted, anaesthetised, mechanically ventilated animals (22.9 ± 2.8 kg) received 0.75 g/kg body weight faeces into the abdominal cavity to induce sepsis and were observed over 6 hours. Animals were randomised to volume replacement therapy with 6% HES 130/0.4 (n = 5), 6% HES 200/0.5 (n = 5), and compared with a nonseptic control group receiving 6% HES 130/0.4 (n = 4). The infusion rate was titrated to maintain a central venous pressure of 12 mmHg. PV was determined using chromium-51-tagged erythrocytes and standard formulae. The albumin escape rate (AER) was calculated using iodine 125-labelled albumin. The cumulative fluid balance (CFB), systemic haemodynamics and oxygenation were measured until 6 hours after induction of sepsis. Statistical comparison was performed using the Wilks Lambda test and the Ryan–Einot–Gabriel–Welsh F test.

Conclusion

In our porcine septic shock model, both 6% HES 130/0.4 and 6% HES 200/05 stabilised PV. Additionally, in comparison with 6% HES 200/05, 6% HES 130/0.4 significantly reduced capillary leakage.

Table 1 Table