ABSTRACT

In this study, we aimed to detect the effects of two commonly used colloid solutions, Hydroxyethyl starch 130/0.4(2000.000 dalton MW)(HES 130) and Gelatin 4 %(30.000 dalton MW) on glomerular capillary leak, which can be used as a surrogate of the systemic capillary leak. We measured the urine microalbumin/creatinine ratio (MACR) to assess the rate of glomerular capillary leak.

The patients who were admitted to the hospital in the past 24 hours, in whom the colloid fluid replacement within the first 24 hours of their ICU stay was indicated, and who were expected to survive more than 48 hours were included in the study.The patients who had diabetes mellitus or known renal diseases were excluded.60 patients were randomly divided into two groups: Group I received HES130(n=30) and Group II received Gelatin 4% at the rate of 12-16 ml/kg/day for 48 hours, in addition to the cristalloid infusions. Sofa Scores; clinical diagnosis of SIRS, sepsis, septic shock, multiorgan failure were noted; blood samples for albumin, BUN, and creatinine levels; urine samples for albumin ve creatinine (microalbumin/creatinine ratio-MACR) ratios were collected; blood –gas analysis results were also recorded on the first and the 48th hours of ICU admission.

There were no difference in MACRs on admission, whereas MACRs were significantly low in HES group on the 48th hours measurements(p<0,05).

We conclude that, the medium molecular weight HES solutions can be a useful tool in limiting the capillary leakage on ICU patients who are under the effect of systemic inflammatory reactions.

Keywords: Capillary leak assesed, glomerular capillary leak, capillary leak syndrome, urine microalbumine/creatinine ratio, MACR, Hydroxyethyl starch, HES, gelatine