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Effect of 6% Hydroxyethyl Starch Solution on Coagulation Function in Patients with Major Burns
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In Suk Kwak, Ji Yeong Bae, Kwang Min Kim
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Korean J Crit Care Med. 2008;23(2):79-83.
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DOI: https://doi.org/10.4266/kjccm.2008.23.2.79
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 Abstract
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- BACKGROUND
Patients with major burns require replacement of intravascular volume. Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. Dilution with crystalloids or colloids and corresponding platelet dysfunction are known causes of perioperative bleeding tendencies. The aim of the current study was to evaluate the effect of crystalloid and colloid solutions on platelet function in patients with major burns.
METHODS
Forty patients scheduled for burn surgery were divided into 4 groups. The infusion was started with a Hartman solution infusion (group 1) from 7 A.M. until surgery. HES (6%, Voluven(R)) was infused in the following concentrations: 7 ml/kg (group 2), 10 ml/kg (group 3), and 15 ml/kg (group 4). The bleeding time (BT), prothrombin time (PT), prothrombin time international ratio (PT INR), activated partial thromboplastin time (aPTT), hemoglobin (Hb), platelet function analyzer-100 closing time (PFA CT), and platelet count (Plt) were measured.
RESULTS
Hartmann solution and HES had no significant effect on the BT, PT, PT INR, a PTT, Hb, and Plt. The post-operative PFA CT was significantly higher in group 4 than in group 3. In group 4, the PFA CT was significantly higher post-operatively compared to pre-operatively.
CONCLUSIONS
The use of high dose HES may increase the risk of bleeding tendencies in burn patients.
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Clinical Study for Monitored Anesthesia Undergoing Ophthalmic Surgery
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Jeong Won Lee, Suk Hun Yoon, Tae Seong Kim, Hyun Soo Kim, Kwang Min Kim
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Korean J Crit Care Med. 1997;12(1):37-42.
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Abstract
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- Intoduction: The phrase "Monitored Anesthesia Care" refers to instances in which an anesthesiologist has been called upon to provide specific anesthesia services to a particular patient understanding a planned procedure, in connection with which a patient receives local anesthesia. Monitored anesthesia care is being increasingly used in the 1990s for a wide variety of diagnostic and therapeutic procedure. The primary objective in providing monitored anesthesia care is to ensure patient comfort and safety.
METHOD
We classified patients in three groups by premedication and oxygen administration, no premedication and no oxygen administration (group A), premedication and oxygen administration (group B), premedication and no oxygen administration (group C), measured vital signs and SpO2 (peripheral oxygen saturation) from just before operation, and checked the satisfaction score of surgeon and patients.
RESULT
SpO2 and satisfaction score of surgeon and patients are the best at premedication and oxygen administration group.
CONCLUSION
Monitored anesthesia is assumed to give more comfort and safety to patients than local anesthesia alone.
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