Objective: To retrospectively analyze the use of hydroxyethyl starch (HES) 130/0.4 in injured patients with acute renal failure (ARF) in Wenchuan earthquake, and its influence on the renal function.
Methods: Critically ill traumatic patients with ARF admitted to intensive care unit (ICU) of West China Hospital within 1 month after Wenchuan earthquake were divided into two groups according to whether or not HES 130/0.4 was used (Y group for having used it and N group for not). The basic clinical data and acute physiology and chronic health evaluation II (APACHE II) score were obtained on admission. Serum blood urea nitrogen (BUN) and creatinine (SCr) on day 1, 3, 7, 14 and 28 were compared between two groups, as well as the time of continuous renal replacement therapy (CRRT) and mechanical ventilation (MV), transfusion amount, and 28-day mortality rate. The usage of HES 130/0.4 was recorded in Y group, including total days, maximum daily amount, total amount and average amount being used.
Results: A total of 39 patients were enrolled into the study, 30 in Y group, 9 in N group. No statistical difference was found in basic clinical data and APACHE II score on admission to ICU. Also there was no difference in days of CRRT and MV, or transfusion amount. Serum BUN and SCr on day 1, 3, 7, 14 and 28 after admission to ICU showed no significant difference between two groups, except for SCr concentration on day 1 (P<0.05). In Y group, the mean duration of using HES 130/0.4 was 3 days, mean daily amount was (529.9+/-226.3) ml, maximum daily amount was 2 500 ml, minimum daily amount was 500 ml (none exceeded recommended dosage), total amount used was 500-13 500 ml. The 28-day mortality rate in Y group was 26.7%, no patient died in N group within 28 days.
Conclusion: No negative influence on the renal function imparted by HES 130/0.4 is found in critically ill traumatic patients with ARF.