The Effects Of AHH By Hydroxyethyl Starch Sodium Acetate Ringer’s Injection On Cardiac Function And Homeostasis

Objective The research is to observe the effects of hydroxyethyl starch sodium acetate ringer’s injection on cardiac function and homeostasis during AHH.Methods30patients, ASA Ⅰ～Ⅱ level,18-65years old, were scheduled for abdominal procedure on supine undergoing general anesthesia, divided into2groups randomly and numbered respectively. Patients were connected with Bioz.Com and monitored Heart Rate, Blood Pressure, Electrocardiogram(ECG), etc. Patients were infused with Lactate Ringer injection6～8ml/kg. The two groups were both intubated through mouth after intravenous fast inducing and muscle relaxant, including Fentanyl4.0ug/kg, Midazolam0.05mg/kg and Propofol1.5～2.5mg/kg, and were infusing with Rocuronium0.6～0.9mg/kg after falling asleep. Patients were rapidly infused with15mL/kg,30mL/min after cardiac funtion parameters are stable. Group V was infused with hydroxyethyl starch sodium acetate ringer’s injection, and group H was hydroxeythyl starch sodium lactate ringer’s injection. The course of AHH was completed before surgery. Many cardiac parameters were reported by BioZ.Com, including HR, Mean Arterial Pressure(MAP), Stroke Volume(SV), Cardiac Output(CO), Systemic Vascular Resistence(SVR) and Thoracic Fluid Content(TFC), respectively in before AHH (T1). the end of AHH immediately (T2), sugery1h (T3), surgery2h (T4) and the end of surgery (T5). Coagulation parameters were reported in T1and after T215min (T2’), including Prothrombin Time(PT), Thrombin Time(TT), Activated Partial Thromboplastin Time(APTT) and Fibrinogen (Fbg). The parameters of blood gas analysis and venous blood electrolyte were reported in T1and T2’, including pH, Base Excess(BE), HCO3-,Glucose(Glu), Lactic acid(Lac) and Na+, K+, Ca2+, Mg2+, Cl-.Results Basic information of the two groups has no difference statistically(P>0.05), including age, gender,height,weight, etc. There are no statistical difference in bleeding, blood transfusion, infusion and urine volume(P>0.05). The comparison of cardiac function parameters in the group:MAP, HR. ACI have no obviously change in every time point(P>0.05); CO, SV were higher than T1after AHH (P<0.05); TFC increased in T2(P<0.01), and returned to T1gradually; SVR decreased in T2(P<0.01), and returned to T1gradually. The comparison of cardiac function parameters in the two groups:There were no obvious difference in every time point (P>0.05). The comparison of coagulation parameters in the group:PT and APTT were prolonged significantly in T2’(P<0.01); TT and Fbg have no obvious change in T2’.The comparison of coagulation parameters in the two group:There were no obvious change in T1and T2’.The comparison of Blood gas analysis in the group: pH, Lac, Glu, HCO3-have no obvious change in T2’; BE in group H was decreased (P<0.05), but group V has no change. The comparison of Blood gas analysis in the two groups:pH, Lac, Glu, HCO3-have no significant difference in T1and T2’; BE in group H was obviously lower than group V (P<0.01). The comparison of Electrolyte in the group:K+, Cl-, Mg2+of group V have no obvious change in T2’; Na+, Mg2+of group V decreased in T2’(P<0.01); K+of group H has no obvious change in T2’; Na+, Ca2+, Mg2+significantly reduced in T2’(P<0.05or P<0.01); Cl-of group H increased significantly (P<0.01). The comparison of Electrolyte in the two groups:all electrolyte parameters have no obvious difference in T1; K+, Na+, Ca2+have no significant difference in T2’; Cl-of group H was obviously higher than that of V (P<0.05); Mg2+of group V was obviously higher than that of group H (P <0.01).Conclusion Hydroxyethyl starch sodium actate ringer’s injection, infusing with15mL/kg,30mL/min, has no obviously adverse effects in cardiac function, coagulation and internal enviroment. It can fully expand blood capacity, reduce allogenetic blood transfusion effctively and avoid hyperchloremia. Hydroxyethyl starch sodium actate ringer’s injection can supply with many kinds of electrolytes timely, improve the quality of anesthesia management, ensure the safety of surgery during perioperative reliably.