Etude de la faisabilite et des effets hemodynamiques de la perfusion d'un volume limite de NaCl a 7.2 %/hydroxyethyl amidon 6% 200/0,5 au cours de la reanimation prehospitaliere et du transport aux urgences de traumatises

Objective: To investigate feasibility and hemodynamic efficacy of small volume infusion of 7.2 % NaCl/6% hydroxyethyl starch 200/0.5 (HS-HES) in trauma patients during prehospital reanimation and transport to an emergency department. Design: Prospective, randomized and controlled study. Materials and Methods: Trauma patients, treated according to the American Trauma Life Support recommendations with a Hannover Trauma Score equal or greater than 10 received or a bolus of 250 ml (HS-HES) or 250 ml of HES alone. Results: In 35 patients (19/16), the initial infusion of 250 ml HES or HS-HES and ongoing infusion therapy increased systolic blood pressure and decreased heart rate similarly in both groups. The supplemental need of colloids (745 ± 134 ml versus 359 ± 93 ml, p < 0.05) and cristalloids (268 ± 81 ml versus 84 ± 43 ml, p < 0.05) administered intravenously was greater in the control group than in the study group. The time interval from infusion of the fluid challenge to arrival at the emergency department was 29 ± 3 min in the control group and 21 ± 4 min in the study group (p < 0.05). Conclusions: This study in trauma patients demonstrates that the administration of 250 ml of HS-HES is feasible. It permits normalization of hemodynamics with a lower volume of colloids and cristalloids in a shorter period.SCOPUS: ar.j