647 Comparison of Balanced 6% Hes Solution to Unbalanced 6% Hes Solution in Hypovolemic Critical Ill Children

Abstract

Goal of the study: The third generation of unbalanced hydrxyethyl starch (HES) (130/04) (Voluven®) shows favorable physicochemical properties and avoids negative effects on coagulation Recently, increasing evidence reported that balanced, plasma-adapted HES preparation (Volulyte®) has advantage over the unbalanced HES solution in chirurgical adult population and avoids hyperchloremic acidosisWe compare the efficacy Volulyte to Voluven in non chirurgical hypovolemic critically ill children. Materials and Methods: Up to 40 ml/kg of the study fluid was infused until stabilization in 20 pediatric patients admitted with circulatory or respiratory failure with shockThe hemodynamic parameters, volume of the study fluid, biological analysis as well as the evolution of the pH, base excess, bicarbonate, chloride and anion gap were analyzed before, after and 24 hours later after administration. Results: After fluid administration and hemodynamic stabilization, no difference in respiratory frequency, ventilatory conditions, kidney, hematological or coagulation values between different treatment groups was observedIn Voluven group (n= 10 patients) however, there was a significantly higher need for treatment volume per kg body weight. The pH, serum base excess, and anion gap were significantly higher in the Volulyte group (n= 10 patients) while the serum chloride remained significantly lower when compared to the Voluven group whereas the serum bicarbonate remained stable. Conclusion: The two study fluid showed no difference in term of hemodynamic, coagulation or kidney functions The Volulyte group showed however, a clear lower serum chloride values as well as less acidosis as indicated by a higher pH and base excess.