Clinical experience of hydroxyethyl starch (10% HES 200/0.5) in cerebral perfusion pressure protocol for severe head injury

Sheng Jean Huang, Yuan Shen Chen, Wei Chen Hong, Lin Chang, Yin Yi Han, Ming Chien Kao, Li Ming Lien, Yong Kwang Tu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The present study was undertaken to evaluate 10% hydroxyethyl starch (HES 200/0.5) with regard to its clinical outcome and safety in the treatment of severe head injury. Methods: Retrospective review of patient data from a prospectively designed standard treatment protocol for severe head injury. The standard protocol included (1) cerebral perfusion pressure higher than 60 mm Hg, (2) colloid solution (10% HES 200/0.5) 1000 mL/d in combination with crystalloid solution, (3) stepwise management of intracranial hypertension. Renal function, coagulation function, and electrolytes were evaluated every other day. The data of intracranial pressure, mean arterial pressure, cerebral perfusion pressure, intake, output, mannitol, complications, and outcome were recorded and analyzed. Results: There were 78 patients, aged 45.61 ± 21.80 years, in this study. The initial Glasgow Coma Scale score was 6.35 ± 1.38. Seventy-three patients received operations with intracranial pressure monitoring. Blood transfusion was surgery related (days 1 and 2); otherwise, it was rarely used (P <.05). Prolonged prothrombin time was shown only 7 (2.65%) times of 234 of blood sampling. There was no anaphylactic reaction, pulmonary complications, or renal function deterioration in the course of our observation. The chart review of the patients at 6 months revealed the following: favorable outcome, 55.1%; unfavorable outcome, 33.3%; and mortality, 11.6%. Conclusions: The 10% HES (200/0.5) can be used in the treatment protocol of severe head injury. There is no definite bleeding complications documented by current dosage of HES. Besides, balanced fluid management can be achieved without causing serious pulmonary complications. However, a further randomized, prospective study is needed to define the actual benefit of HES in fluid management and clinical outcome.

Original languageEnglish
Pages (from-to)S26-S31
JournalSurgical Neurology
Volume66
Issue numberSUPPL. 2
DOIs
Publication statusPublished - Nov 2006
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Craniocerebral Trauma
Starch
Intracranial Pressure
Clinical Protocols
Kidney
Lung
Glasgow Coma Scale
Intracranial Hypertension
Prothrombin Time
Colloids
Mannitol
Anaphylaxis
Ambulatory Surgical Procedures
Blood Transfusion
Electrolytes
Arterial Pressure
Observation
Prospective Studies
Hemorrhage

Keywords

  • CPP-targeted therapy
  • Hydroxyethyl starch
  • Pentarstarch
  • Severe head injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Clinical experience of hydroxyethyl starch (10% HES 200/0.5) in cerebral perfusion pressure protocol for severe head injury. / Huang, Sheng Jean; Chen, Yuan Shen; Hong, Wei Chen; Chang, Lin; Han, Yin Yi; Kao, Ming Chien; Lien, Li Ming; Tu, Yong Kwang.

In: Surgical Neurology, Vol. 66, No. SUPPL. 2, 11.2006, p. S26-S31.

Research output: Contribution to journalArticle

Huang, Sheng Jean ; Chen, Yuan Shen ; Hong, Wei Chen ; Chang, Lin ; Han, Yin Yi ; Kao, Ming Chien ; Lien, Li Ming ; Tu, Yong Kwang. / Clinical experience of hydroxyethyl starch (10% HES 200/0.5) in cerebral perfusion pressure protocol for severe head injury. In: Surgical Neurology. 2006 ; Vol. 66, No. SUPPL. 2. pp. S26-S31.
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abstract = "Background: The present study was undertaken to evaluate 10{\%} hydroxyethyl starch (HES 200/0.5) with regard to its clinical outcome and safety in the treatment of severe head injury. Methods: Retrospective review of patient data from a prospectively designed standard treatment protocol for severe head injury. The standard protocol included (1) cerebral perfusion pressure higher than 60 mm Hg, (2) colloid solution (10{\%} HES 200/0.5) 1000 mL/d in combination with crystalloid solution, (3) stepwise management of intracranial hypertension. Renal function, coagulation function, and electrolytes were evaluated every other day. The data of intracranial pressure, mean arterial pressure, cerebral perfusion pressure, intake, output, mannitol, complications, and outcome were recorded and analyzed. Results: There were 78 patients, aged 45.61 ± 21.80 years, in this study. The initial Glasgow Coma Scale score was 6.35 ± 1.38. Seventy-three patients received operations with intracranial pressure monitoring. Blood transfusion was surgery related (days 1 and 2); otherwise, it was rarely used (P <.05). Prolonged prothrombin time was shown only 7 (2.65{\%}) times of 234 of blood sampling. There was no anaphylactic reaction, pulmonary complications, or renal function deterioration in the course of our observation. The chart review of the patients at 6 months revealed the following: favorable outcome, 55.1{\%}; unfavorable outcome, 33.3{\%}; and mortality, 11.6{\%}. Conclusions: The 10{\%} HES (200/0.5) can be used in the treatment protocol of severe head injury. There is no definite bleeding complications documented by current dosage of HES. Besides, balanced fluid management can be achieved without causing serious pulmonary complications. However, a further randomized, prospective study is needed to define the actual benefit of HES in fluid management and clinical outcome.",
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T1 - Clinical experience of hydroxyethyl starch (10% HES 200/0.5) in cerebral perfusion pressure protocol for severe head injury

AU - Huang, Sheng Jean

AU - Chen, Yuan Shen

AU - Hong, Wei Chen

AU - Chang, Lin

AU - Han, Yin Yi

AU - Kao, Ming Chien

AU - Lien, Li Ming

AU - Tu, Yong Kwang

PY - 2006/11

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N2 - Background: The present study was undertaken to evaluate 10% hydroxyethyl starch (HES 200/0.5) with regard to its clinical outcome and safety in the treatment of severe head injury. Methods: Retrospective review of patient data from a prospectively designed standard treatment protocol for severe head injury. The standard protocol included (1) cerebral perfusion pressure higher than 60 mm Hg, (2) colloid solution (10% HES 200/0.5) 1000 mL/d in combination with crystalloid solution, (3) stepwise management of intracranial hypertension. Renal function, coagulation function, and electrolytes were evaluated every other day. The data of intracranial pressure, mean arterial pressure, cerebral perfusion pressure, intake, output, mannitol, complications, and outcome were recorded and analyzed. Results: There were 78 patients, aged 45.61 ± 21.80 years, in this study. The initial Glasgow Coma Scale score was 6.35 ± 1.38. Seventy-three patients received operations with intracranial pressure monitoring. Blood transfusion was surgery related (days 1 and 2); otherwise, it was rarely used (P <.05). Prolonged prothrombin time was shown only 7 (2.65%) times of 234 of blood sampling. There was no anaphylactic reaction, pulmonary complications, or renal function deterioration in the course of our observation. The chart review of the patients at 6 months revealed the following: favorable outcome, 55.1%; unfavorable outcome, 33.3%; and mortality, 11.6%. Conclusions: The 10% HES (200/0.5) can be used in the treatment protocol of severe head injury. There is no definite bleeding complications documented by current dosage of HES. Besides, balanced fluid management can be achieved without causing serious pulmonary complications. However, a further randomized, prospective study is needed to define the actual benefit of HES in fluid management and clinical outcome.

AB - Background: The present study was undertaken to evaluate 10% hydroxyethyl starch (HES 200/0.5) with regard to its clinical outcome and safety in the treatment of severe head injury. Methods: Retrospective review of patient data from a prospectively designed standard treatment protocol for severe head injury. The standard protocol included (1) cerebral perfusion pressure higher than 60 mm Hg, (2) colloid solution (10% HES 200/0.5) 1000 mL/d in combination with crystalloid solution, (3) stepwise management of intracranial hypertension. Renal function, coagulation function, and electrolytes were evaluated every other day. The data of intracranial pressure, mean arterial pressure, cerebral perfusion pressure, intake, output, mannitol, complications, and outcome were recorded and analyzed. Results: There were 78 patients, aged 45.61 ± 21.80 years, in this study. The initial Glasgow Coma Scale score was 6.35 ± 1.38. Seventy-three patients received operations with intracranial pressure monitoring. Blood transfusion was surgery related (days 1 and 2); otherwise, it was rarely used (P <.05). Prolonged prothrombin time was shown only 7 (2.65%) times of 234 of blood sampling. There was no anaphylactic reaction, pulmonary complications, or renal function deterioration in the course of our observation. The chart review of the patients at 6 months revealed the following: favorable outcome, 55.1%; unfavorable outcome, 33.3%; and mortality, 11.6%. Conclusions: The 10% HES (200/0.5) can be used in the treatment protocol of severe head injury. There is no definite bleeding complications documented by current dosage of HES. Besides, balanced fluid management can be achieved without causing serious pulmonary complications. However, a further randomized, prospective study is needed to define the actual benefit of HES in fluid management and clinical outcome.

KW - CPP-targeted therapy

KW - Hydroxyethyl starch

KW - Pentarstarch

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