LACTATED RINGERS SOLUTION VERSUS HYDROXYETHYL STARCH FOR VOLUME REPLACEMENT IN AUTOLOGOUS BLOOD-DONORS WITH CARDIOVASCULAR-DISEASE - A CONTROLLED, RANDOMIZED TRIAL

Background and Objectives: The study was designed to evaluate whether volume replacement following blood donation can prevent arterial hypot ension in autologous blood donors with cardiovascular disease. Materia ls and Methods: One hundred nineteen autologous blood donors with know n cardiovascular disease were randomly allocated to receive, following withdrawal of 500 ml of blood, either no infusion (control group) or a 25 ml/min intravenous infusion of either 1,500 ml of lactated Ringer 's solution (LRS) or 500 ml of 6% hydroxyethyl starch (HES). Starting before phlebotomy, arterial blood pressure was measured oscillometrica lly every 5 min until 90 min after donation. Results: Group means show ed little difference between the groups in blood pressure throughout t he monitoring period. The proportion of patients who at least once had a greater than or equal to 20% decrease from baseline in systolic blo od pressure was 3-5 times greater in the control group than in the LRS and the HES group (50 vs. 10 and 15%, respectively; p < 0.001 on chi( 2) analysis for a 2 x 3 table). Systolic hypertensive episodes (greate r than or equal to 20% increase over baseline) were observed more freq uently in the LRS group than in the control and the HES group (41 vs. 10 and 18%, respectively; p = 0.003). Conclusion: Both LRS and HES, ad ministered at a volume ratio to blood loss of 3:1 and 1:1, respectivel y, significantly reduced the incidence of systolic hypotensive episode s in autologous blood donors with cardiovascular disease. LRS at a 3:1 volume ratio to blood loss was associated with a high rate of systoli c hypertension.