Plasma volume expansion by medium molecular weight hydroxyethyl starch in neonates: a pilot study

Pediatr Crit Care Med. 2003 Jul;4(3):305-7. doi: 10.1097/01.PCC.0000074262.84240.1E.

Abstract

Objective: To study the renal effects (measured by creatininemia) of plasma volume expansion with a medium molecular weight hydroxyethyl starch in the newborn.

Design: A prospective, randomized, double-blinded, pilot study.

Patients: The study included 26 neonates weighing 690-4030 g (gestational age, 26-40 wks), without cardiac or renal failure or major hemostasis abnormalities and requiring a peripherally inserted central catheter for parenteral nutrition.

Setting: Pediatric and neonatal intensive care unit of a university-affiliated hospital.

Interventions: Plasma volume expansion was performed to facilitate insertion of the central catheter. After parental consent, neonates were randomly allocated to receive intravenous infusions at 10 mL.kg(-1) of 5% albumin or 6% hydroxyethyl starch 200/0.5. Sample size was calculated to detect an increase in mean creatininemia of >20 micromol.L(-1) (with alpha = 0.05, beta = 0.80).

Measurements and main results: No clinically or statistically significant differences were found between the two groups 6 hrs, 24 hrs, 48 hrs, and 7 days after plasma volume expansion. The study could detect an increase in creatininemia > or =20 micromol.L(-1) with a power of 80%.

Conclusions: In 13 healthy neonates, plasma volume expansion with 10 mL.kg(-1) of 6% hydroxyethyl starch 200/0.5 does not increase creatininemia.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Age Factors
  • Albumins / administration & dosage
  • Albumins / pharmacology
  • Blood Substitutes / administration & dosage
  • Blood Substitutes / pharmacology*
  • Double-Blind Method
  • Female
  • Humans
  • Hydroxyethyl Starch Derivatives / administration & dosage
  • Hydroxyethyl Starch Derivatives / pharmacology*
  • Infant, Newborn*
  • Infant, Premature
  • Kidney / drug effects*
  • Male
  • Molecular Weight
  • Parenteral Nutrition
  • Pilot Projects
  • Prospective Studies
  • Time Factors

Substances

  • Albumins
  • Blood Substitutes
  • Hydroxyethyl Starch Derivatives