Crystalloids versus colloids for goal-directed fluid therapy in major surgery

Table 1 Systemic, regional, and local hemodynamic variables

	Heart rate^{a, b} (beats per minute)	SV^b (mL/beat)	SVRI^{a, b} (mm Hg/kg per minute)	CVP (mm Hg)	HVP (mm Hg)	PCWP^b (mm Hg)	CeliacusI (mL/kg per minute)	MBF JM^{a, b} (percentage of baseline)
Restricted Ringer lactate solution (R-RL)
0 minutes	117 ± 2	28.1 ± 8.4	732 ± 84	2.8 ± 1	3.8 ± 1.4	3.1 ± 0.6	4.0 ± 0.9	100 ± 0
30 minutes	117 ± 4	26.6 ± 6.7	744 ± 123	3.1 ± 0.8	4.5 ± 1	3.3 ± 0.7	4.1 ± 1.0	93 ± 20
180 minutes	123 ± 15	23.7 ± 5.7	868 ± 161	3.3 ± 0.7	3.9 ± 1.4	3.2 ± 0.9	4.9 ± 1.2	74 ± 24
240 minutes	128 ± 14	24.2 ± 5.2	835 ± 149	2.8 ± 1.1	3.9 ± 0.9	2.9 ± 0.7	5.1 ± 1.1	71 ± 18
Goal-directed Ringer lactate solution (GD-RL)
0 minutes	110 ± 11	25.4 ± 6.6	705 ± 140	3 ± 1.1	4.3 ± 1.4	3.3 ± 1.1	3.8 ± 1.4	100 ± 0
30 minutes	101 ± 4	28.3 ± 7	652 ± 157	3.3 ± 1.1	4.6 ± 1.1	3.6 ± 1	3.9 ± 1.5	97 ± 22
180 minutes	106 ± 15^a	30.8 ± 6.5	666 ± 147	3.8 ± 1.1	5.5 ± 0.9	3.9 ± 1.2	6.2 ± 1.7	54 ± 18
240 minutes	103 ± 18^{a, c}	33.2 ± 6.7	646 ± 90^a	4 ± 0.9	5.6 ± 1	4.4 ± 1.2	5.8 ± 1.1	49 ± 11
Goal-directed colloid solution (GD-C)
0 minutes	113 ± 7	25.2 ± 9.8	682 ± 155	3 ± 0.7	4.1 ± 0.9	3.3 ± 0.5	4.3 ± 1.3	100 ± 0
30 minutes	98 ± 9	38.7 ± 7.3^d	589 ± 76	4.3 ± 0.7^d	5.4 ± 1	4.6 ± 0.8	5.0 ± 1.5	122 ± 19
180 minutes	106 ± 16^d	35.1 ± 11^d	622 ± 109^d	3.8 ± 1.1	5.1 ± 1	3.9 ± 1.1	5.4 ± 1.5	101 ± 19^{d, e}
240 minutes	109 ± 20^d	33.9 ± 12	563 ± 53^d	4.2 ± 0.9^d	5.7 ± 0.9	3.7 ± 0.9	5.4 ± 1.5	94 ± 22^{d, e}

Data are presented as mean ± standard deviation. Microcirculatory blood flow was set at 100% at t = 0 minutes. t = 0 baseline values are from before the start of the respective fluid therapy. At t = 30 minutes, effects of one fluid bolus, 250 mL of lactated Ringer solution in the GD-LR group or hydroxyethyl starch in the GD-C group, are presented. At t = 240 minutes, effects after an additional 1,794 ± 211 mL of lactated Ringer solution in the GD-LR group and an additional 831 ± 267 mL of hydroxyethyl starch (130/0.4) in the GD-C group are presented. Significant differences (P < 0.05) for area under the curve: ^aR-RL versus GD-RL, ^bR-RL versus GD-C. Significant differences (P < 0.05) for analysis of variance for repeated measurements (Tukey post hoc test): ^cR-RL versus GD-RL, ^dR-RL versus GD-C, ^eGD-RL versus GD-C. The R-RL group received 3 mL/kg per hour of lactated Ringer solution throughout the entire experiment. The GD-RL group received 3 mL/kg per hour of lactated Ringer solution plus 250 mL of lactated Ringer solution if SvO₂ was less than 60%. The GD-C group received 3 mL/kg per hour of lactated Ringer solution plus 250 mL of hydroxyethyl starch (130/0.4) if SvO₂ was less than 60%. CeliacusI, truncus celiacus flow index; CVP, central venous pressure; HVP, hepatic venous pressure; MBF JM, microcirculatory blood flow in the muscularis of the jejunum; PCWP, pulmonary capillary wedge pressure; SV, stroke volume; SVRI, systemic vascular resistance index.

ISSN: 1364-8535