Clinical trial NCT00542516: Comparison Between Two Techniques of Volemic Expansion in Hip Replacement Arthroplasty
Official title: Comparison Between Two Techniques of Volemic Expansion in Hip Replacement Arthroplasty: Hydroxyethyl Starch Versus Ringer's Lactate
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Hip Replacement Arthroplasty
Keywords: Hip Replacement Arthroplasty
Hydroxyethyl Starch
Hemodilution
Hetastarch
Colloids
Lead sponsor: University of Sao Paulo
Sponsor class: OTHER
First posted: 2007-10-11
Enrollment: 48
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Currently the most use solution to volemic reposition in hip replacement arthroplasty is the crystalloid solution. This trial intends to compare two different volemic replacements: HES and Ringer's lactate. This research has been analyzing hemodynamic parameters and the coagulation status before and after the pre-expansion with the solutions above mentioned.

Detailed description: This trial is randomized an blind to the physician who is analyzing the results.It has been select adults; both sex; ASA I and II. These patients must be submitted to hip arthroplasty replacement. The anesthesia technique is single shot spinal anesthesia. Primary endpoint: assessment alternative; technique replacement volemic with HES 130/04. Secondary endpoint: haemostatic abnormalities; blood loss; transfusion blood.

Eligibility criteria: Inclusion Criteria:

* Patients involved: adults, ASA I and II;
* Surgery: hip replacement arthroplasty.

Exclusion Criteria:

* Allergy starch;
* Anemia;
* Dysfunction renal;
* Heart insufficiency;
* Morbid obesity.

Primary outcomes:
measure: HES expansion plasmatic efficacy
timeFrame: 24 hours
Secondary outcomes:
measure: Blood transfusion
timeFrame: 24 hours
measure: Haemostatic alterations
timeFrame: 24 hours
Other outcomes:
Locations:
city: São Paulo
country: Brazil
facility: Institute of Orthopedics and Traumatology of HCFMUSP
Study officials:
affiliation: Hospital das Clínicas - Medicine School of the University of São Paulo
name: José Otávio C Auler Junior, PhD/Chairman
role: STUDY_CHAIR
References:
citation: Langeron O, Doelberg M, Ang ET, Bonnet F, Capdevila X, Coriat P. Voluven, a lower substituted novel hydroxyethyl starch (HES 130/0.4), causes fewer effects on coagulation in major orthopedic surgery than HES 200/0.5. Anesth Analg. 2001 Apr;92(4):855-62. doi: 10.1097/00000539-200104000-00011.
citation: Gallandat Huet RC, Siemons AW, Baus D, van Rooyen-Butijn WT, Haagenaars JA, van Oeveren W, Bepperling F. A novel hydroxyethyl starch (Voluven) for effective perioperative plasma volume substitution in cardiac surgery. Can J Anaesth. 2000 Dec;47(12):1207-15. doi: 10.1007/BF03019870.
citation: Haisch G, Boldt J, Krebs C, Kumle B, Suttner S, Schulz A. The influence of intravascular volume therapy with a new hydroxyethyl starch preparation (6% HES 130/0.4) on coagulation in patients undergoing major abdominal surgery. Anesth Analg. 2001 Mar;92(3):565-71. doi: 10.1097/00000539-200103000-00003.
citation: Jungheinrich C, Scharpf R, Wargenau M, Bepperling F, Baron JF. The pharmacokinetics and tolerability of an intravenous infusion of the new hydroxyethyl starch 130/0.4 (6%, 500 mL) in mild-to-severe renal impairment. Anesth Analg. 2002 Sep;95(3):544-51, table of contents. doi: 10.1097/00000539-200209000-00007.
citation: Boldt J, Suttner S. Plasma substitutes. Minerva Anestesiol. 2005 Dec;71(12):741-58.
citation: Mielke LL, Entholzner EK, Kling M, Breinbauer BE, Burgkart R, Hargasser SR, Hipp RF. Preoperative acute hypervolemic hemodilution with hydroxyethylstarch: an alternative to acute normovolemic hemodilution? Anesth Analg. 1997 Jan;84(1):26-30. doi: 10.1097/00000539-199701000-00005.
citation: Gandhi SD, Weiskopf RB, Jungheinrich C, Koorn R, Miller D, Shangraw RE, Prough DS, Baus D, Bepperling F, Warltier DC. Volume replacement therapy during major orthopedic surgery using Voluven (hydroxyethyl starch 130/0.4) or hetastarch. Anesthesiology. 2007 Jun;106(6):1120-7. doi: 10.1097/01.anes.0000265422.07864.37.
citation: Otsuki DA, Fantoni DT, Margarido CB, Marumo CK, Intelizano T, Pasqualucci CA, Costa Auler JO Jr. Hydroxyethyl starch is superior to lactated Ringer as a replacement fluid in a pig model of acute normovolaemic haemodilution. Br J Anaesth. 2007 Jan;98(1):29-37. doi: 10.1093/bja/ael312. Epub 2006 Nov 26.