Formation (MCF) considerable larger than 6 HES 130:0.4 and 6 HES 200:0.five alone.

Formation (MCF) considerable larger than 6 HES 130:0.4 and 6 HES 200:0.five alone. Conclusion: Concerning to our data, six HES 200:0.five along with the combination of six HES 200:0.5/RL impair the coagulation method more than the mixture of gelatien/RL or 6 HES 130:0.4/RL. Concerning its influence around the coagulation method, six HES 130:0.four may well be as secure as gelatine in individuals with blood loss and huge volume substitution.SAvailable online http://ccforum.com/supplements/5/SP113 Substantial volume resuscitation with hydroxyethyl starch (HES) in lactated Ringer’s (LR) option restores perfusion, minimallyinduces hyperchloremia or impairs coagulationLJ Kaplan, H Bailey MCP-Hahnemann University, 3300 Henry Avenue, Philadelphia, PA 19129, USA Objective: To evaluate the impact of massive volume (> 25 cc/kg bw) Hextend (HES in LR) resuscitation on perfusion, hyperchloremic metabolic acidosis and coagulation. Solutions: A comfort sample of ICU patients resuscitated by a single Intensivist at a University hospital making use of > 25 cc/kg bw of Hextend as aspect a resuscitation method was retrospectively examined. Individuals had been divided into 3 groups: trauma, sepsis, and post-op. IRB authorized information integrated: age, sex, principal diagnosis, laboratory information, and fluid volumes. Thriving resuscitation was defined as resolution of lactic acidemia. Information were divided into admission and 24 hour values and compared making use of a two-tailed, paired t-test. Information have been compared applying a LF3 custom synthesis t-test or chi-square; significance assumed for P < 0.05 (*). Results: Patient mix was 54 trauma, 34 sepsis, and 12 postop. Of the trauma patients, 17 had traumatic brain injury, and 23 were receiving blood components on a massive transfusion protocol. All patients were mechanically ventilated and 26 were admitted with a coagulopathy. 36 of patients were admitted with a hyperchloremic metabolic acidosis. 78 of patients also had evidence of lactic acidosis on admission. 82 of trauma, 64 of sepsis, and 92 of post-op patients cleared their lactic acidemia by 24 hours. Mean HEX volumes were 38 ?4 cc/kg bw (trauma), 31 ?4 cc/kg bw (sepsis) and 27 ?5 cc/kg bw (post-op). Chloride concentration remained unchanged no patients; decreased in 94 * (trauma), 100 sepsis, and 100 post-op patients; and increased in 6 * (trauma), 0 sepsis, and 0 post-op patients. PT/PTT remained unchanged in 0 * (trauma), 90 sepsis, and 95 post-op patients; decreased in 97 * (trauma), 7 sepsis, and 3 post-op patients; and increased in 3 (trauma), 3 sepsis, and 2 post-op patients. The mean pre-resuscitation pH was 7.24 ?0.12 (trauma), 7.32 ?0.09 (sepsis) and 7.35 ?0.8 (post-op) while the mean pH at 24 hours was 7.36 ?0.09* (trauma), 7.37 ?0.05 (sepsis), and 7.39 ?0.08 (post-op). Conclusions: Hextend may be used as part of a large volume resuscitation strategy in diverse patient populations including those with traumatic brain injury. Hextend helps minimize the hyperchloremia associated with massive volume resuscitation without significantly perturbing the serine protease dependent coagulation profile.P114 Advantages of 6 hydroxyethyl starch 130/0.4 (Voluven? at repetitive high dose levels in patients with severe cranio-cerebral traumaThA Neff*, C Jungheinrich, PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 M Doelberg, A Sauerland, DR Spahn*, R Stocker *Institute of Anesthesiology, and Division of Surgical Intensive Care, University Hospital Zurich, Switzerland; Clinical Research, Fresenius Kabi, 61346 Negative Homburg, Germany Introduction: Concerning the use of high.