EFFICIENCY AND SAFETY OF USING HYDROXYETHYL STARCH IN THE BURN SHOCK MANAGEMENT

The retrospective cohort comparative study was conducted in order to evaluate efficiency and safety of using 6% hydroxyethyl starch (HES) 130/0.4 for managing burn shock. The enrollment criteria were as follows: men and women above 18 years old, thermal burns from 20 to 80% of the body surface, the need of infusion therapy, expected duration of the patient’s stay in the intensive care department for more than 3 days, the absence of acute renal failure at the moment of hospital admission. All patients were divided into two groups. The 1st group (HES+) included 24 patients who received infusion therapy for 3 days with Ringer’s solution and 6% HES 130/0.4 additionally, the 2nd group (HES-) included 25 patients who were treated only with Ringer’s solution. Hospital mortality in the group (HES+) made 45.8% (11 patients died), and in the group (HES-) it made 28.0% (7 patients died), p = 0.3182. The extended surface of lesion was the independent factor of acute renal failure development in those suffering from severe burn injury: OR = 1.09 (1.01–1.19), p = 0.04; Baux OR greater index = 1.09 (1.01–1.19), p = 0.02 and the need in catecholamines – OR = 12.7 (1.2–144.9), p = 0.04. The study showed no confident difference in the frequency of acute renal failure, in the need of substitution renal therapy and mortality in two groups of patients receiving and not receiving HES. Using HES solutions in doses not exceeding the recommended ones did not facilitated the reduction of infusion therapy volume.

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