Research On Clinical Of Hydroxyethyl Starch 130/0.4 Used For Cardiopulmonary Bypass In Infants

Objective:(1)The goal discusses when Voluven applies priming in the infants heart surgery external circulation(Extracorporeal circulation ECC),is encircling external circulation period to blood plasma colloid osmotic pressure(COP)and lactic acid(Lac)level influence.(2)To investigate the effects of hydroxyethyl starch 130/0.4(HES)used as priming fliud for cardiopulmonary bypass(CPB)on hepato-renal function and coagulation in infants undergoing cardiac surgery.Methods:40 examples have the infants in the external circulation downward heart who regards the surgery,in 4 months≤the age≤6 years old,randomly divides into voluven group(n=20)and the plasma group(n=20),the observation different point in time[before operation patient,priming fluid,ECC 5 minute,ECC 30 minute,convention ultra filters in front of(CUF),stops in front of ECC,ICU(2-3h)] the blood plasma COP value,observes COP the change tendency,appraises two priming methods to the blood plasma COP influence.Observes the different point in time(before ECC,5 minutes after interruption of aorta,to stop ECC,surgery ended) the artery blood gas,the average arterial pressure,the nose warm and so on the targets.Contrasts two priming methods to the lactic acid level and other target influence:and the blood sample were taken from the vein at the one day before operation(T0)and at the end of operation(T1)for ALT,TBIL,UREA,Creutinine(Cr),PT,APTT,TT,Fbg monitering records two group of patient operation latter 24 hour storehouse blood amount used,the amount of urine, the belt tube time and the chest cavity drainage quantity.Records in two group of patient's extensions the amount of urine,the convention ultra filters the liquid quantity which the quantity and improves ultra filters.Result:Priming fluid COP of Voluven and Plasma are 21.5±7.0mmHg(1mmHg=0.133kPa),13.7±3.5mmHg,respectively(P=0.000).Voluven blood plasma COP is higher than the blood plasma group obviously at the same point (26.8±2.5mmHg & 25.7±3.1mmHg,22.2±2.6mmHg & 18.0±2.5mmHg,22.3± 2.5mmHg & 19.2±2.5mmHg,22.2±2.5mmHg & 19.3±2.1mmHg,26.2±3.9mmHg & 22.3±4.3mmHg,31.3±3.3mmHg & 28.9±3.0mmHg,P＜0.01), Voluven the Lac level is lower than the blood plasma group the Lac level(0.5±0.4mmol/L & 0.6±0.3mmol/L,1.7±0.6mmol/L & 2.6±0.8mmol/L,2.4±0.8mmol/L & 3.5±1.2mmol/L,1.3±0.5mmol/L & 2.2±1.0mmol/L,P＜0.01), Voluven the Ph value level to be lower than the blood plasma group obviously(P＜0.05);The serum ALT,TBIL,Cr were significant lower in HES group than in plasma group(P＜0.05).The PT,APTT,Fbg were significant longer in HES group than in plasma group(P＜0.05).other observation target two groups not to have the significant difference.Conlusion:Voluven applies priming in the infants heart surgery external circulation can effective enhance blood plasma COP,moreover can reduce in the blood the lactic acid leve;have not side effect on hepato-renal function and have beneficial effects.HES130/0.4 have some side effects on coagulation,but have not found abvois blooding in clinica...