USE OF MODIFIED FLUID GELATIN AND HYDROXYETHYL STARCH FOR COLLOIDAL VOLUME REPLACEMENT IN MAJOR ORTHOPEDIC-SURGERY

We have compared 5% hydroxyethyl starch (HES 200/0.5) with 3% modified fluid gelatin (MFG) for volume replacement in major orthopaedic surge ry and studied the effects on haemodynamic stare, colloid osmotic pres sure, blood clotting and plasma homeostasis. Using a controlled, rando mized, single-blind clinical design, we studied 46 consecutive patient s undergoing major elective orthopaedic hip surgery. The two groups we re comparable in age, body weight and duration of surgery. Patients we re maintained haemodynamically stable using both HES and MFG over the entire study, Fluid balance and colloidal replacement volumes were com parable in both groups (median perioperative infusion volume: HES 2500 ml, MFG 2400 ml). Laboralory variables were not clinically different. We conclude that both colloidal solutions were comparable in volume e fficacy and effects on plasma oncotic pressure, clotting and plasma ho meostasis. In the small number of patients studied, 5% HES 200/0.5 was found to be safe when administered in amounts corresponding to the cu rrently accepted maximum daily dose in Germany and France of 33 ml/kg body weight and 2.0 g/kg body weight, respectively.