Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon

2.50
Hdl Handle:
http://hdl.handle.net/2336/66793
Title:
Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon
Authors:
Kimberger, Oliver; Arnberger, Michael; Brandt, Sebastian; Plock, Jan; Sigurdsson, Gisli H; Kurz, Andrea; Hiltebrand, Luzius
Citation:
Anesthesiology. 2009, 110(3):496-504
Issue Date:
1-Mar-2009
Abstract:
BACKGROUND: The aim of this study was to compare the effects of goal-directed colloid fluid therapy with goal-directed crystalloid and restricted crystalloid fluid therapy on healthy and perianastomotic colon tissue in a pig model of colon anastomosis surgery. METHODS: Pigs (n = 27, 9 per group) were anesthetized and mechanically ventilated. A hand-sewn colon anastomosis was performed. The animals were subsequently randomized to one of the following treatments: R-RL group, 3 ml x kg(-1) x h(-1) Ringer lactate (RL); GD-RL group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of RL; GD-C group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of hydroxyethyl starch (HES 6%, 130/0.4). A fluid bolus was administered when mixed venous oxygen saturation dropped below 60%. Intestinal tissue oxygen tension and microcirculatory blood flow were measured continuously. RESULTS: After 4 h of treatment, tissue oxygen tension in healthy colon increased to 150 +/- 31% in group GD-C versus 123 +/- 40% in group GD-RL versus 94 +/- 23% in group R-RL (percent of postoperative baseline values, mean +/- SD; P < 0.01). Similarly perianastomotic tissue oxygen tension increased to 245 +/- 93% in the GD-C group versus 147 +/- 58% in the GD-RL group and 116 +/- 22% in the R-RL group (P < 0.01). Microcirculatory flow was higher in group GD-C in healthy colon. CONCLUSIONS: Goal-directed colloid fluid therapy significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal-directed or restricted crystalloid fluid therapy.
Description:
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Additional Links:
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Full metadata record

DC FieldValue Language
dc.contributor.authorKimberger, Oliver-
dc.contributor.authorArnberger, Michael-
dc.contributor.authorBrandt, Sebastian-
dc.contributor.authorPlock, Jan-
dc.contributor.authorSigurdsson, Gisli H-
dc.contributor.authorKurz, Andrea-
dc.contributor.authorHiltebrand, Luzius-
dc.date.accessioned2009-04-30T15:31:32Z-
dc.date.available2009-04-30T15:31:32Z-
dc.date.issued2009-03-01-
dc.date.submitted2009-04-30-
dc.identifier.citationAnesthesiology. 2009, 110(3):496-504en
dc.identifier.issn1528-1175-
dc.identifier.pmid19225390-
dc.identifier.doi10.1097/ALN.0b013e31819841f6-
dc.identifier.urihttp://hdl.handle.net/2336/66793-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: The aim of this study was to compare the effects of goal-directed colloid fluid therapy with goal-directed crystalloid and restricted crystalloid fluid therapy on healthy and perianastomotic colon tissue in a pig model of colon anastomosis surgery. METHODS: Pigs (n = 27, 9 per group) were anesthetized and mechanically ventilated. A hand-sewn colon anastomosis was performed. The animals were subsequently randomized to one of the following treatments: R-RL group, 3 ml x kg(-1) x h(-1) Ringer lactate (RL); GD-RL group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of RL; GD-C group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of hydroxyethyl starch (HES 6%, 130/0.4). A fluid bolus was administered when mixed venous oxygen saturation dropped below 60%. Intestinal tissue oxygen tension and microcirculatory blood flow were measured continuously. RESULTS: After 4 h of treatment, tissue oxygen tension in healthy colon increased to 150 +/- 31% in group GD-C versus 123 +/- 40% in group GD-RL versus 94 +/- 23% in group R-RL (percent of postoperative baseline values, mean +/- SD; P < 0.01). Similarly perianastomotic tissue oxygen tension increased to 245 +/- 93% in the GD-C group versus 147 +/- 58% in the GD-RL group and 116 +/- 22% in the R-RL group (P < 0.01). Microcirculatory flow was higher in group GD-C in healthy colon. CONCLUSIONS: Goal-directed colloid fluid therapy significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal-directed or restricted crystalloid fluid therapy.en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00000542-200903000-00013&LSLINK=80&D=ovften
dc.subject.meshAnastomosis, Surgicalen
dc.titleGoal-directed colloid administration improves the microcirculation of healthy and perianastomotic colonen
dc.typeArticleen
dc.contributor.departmentDepartment of Anesthesiology and Pain Therapy, Inselspital-University Hospital Bern, Switzerland. study@kimberger.aten
dc.identifier.journalAnesthesiologyen
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