Balanced Versus Unbalanced Hydroxyethyl Starch Solutions the Effect on Acid-Base Status and Renal Functions in Major Urosurgical Procedures

Background: The safety and efficacy of hydroxyethyl starch (HES) for fluid resuscitation have not been fully evaluated, and adverse effects of HES on survival, renal function and acid base status have been reported.Methods: 40 patients who had been enrolled in the study 4 patients had to be excluded. 36 patients completed the study. This prospective, randomized, study was designed to prove therapeutic equivalence of both HES formulations regarding the volume effect within a predePned interval and to evaluate the effects of 0.9% saline-based (Voluven, Fresenius Kabi, Bad Hom-bourg, Germany) (VOL group: n = 17) and balanced 6% tetrastarch (Tetraspan, B. Braun, Melsungen, Germany) (TET group: n = 19). Solutions on acid base status and renal function in patients underwent radical prostatectomy or cystectomy with bladder replacement.The Primary outcome was the volume of the study drug in milliliters that will be needed for hemodynamic stabilization until the end of surgery (i.e, the cumulative volume of the study drug in milliliters administered up to this time point). The secondry outcome was the differences in the plasma creatinine concentrations and in acid-base homeostasis (PH, PaC 2, PaCC 2, HCO3) among the study groups.Results: The main finding of the study described herein was that both 6% HES 130/0.4 either in normal saline (voluven) or in balanced electrolyte solution (tetraspan) have the same efficacy in restoring blood volume without any significant alteration in either acid base or serum electrolyte level in patients undergoing urosurgical procedures.Conclusion: This study showed that both balanced 6% HES 130/0.4 (Tetraspan) and saline-based 6% HES 130/0.4 (Voluven) were equally effective for hemodynamic stabilization of patients undergoing major urologic procedures without any significant impact on acid base or renal function.