Background and Aims There is limited data according the use of 6% solution of hydroxyethyl starch 130/0.42 in volemic resuscitation for neonates. The aim of the study was to compare the efficiency of 6% HES 130/0.42 and normal saline in the intensive care of term newborns with severe HIE.
Methods 15 full-term neonates with HIE were included. Score Sarnat II was in 9 newborns and Sarnat III was in 6 babies. The mean gestation age was 39.3±0.2 weeks. Apgar score at 1st minute was 3.8±0.1 and at 5th minute was 6.0±0.1. Routine hemodynamic parameters, lab studies and cerebral perfusion pressure (CPP = 1.1 ∙ (Vs – Vd)/PI – 5 mm Hg) by transfontanel Doppler (Aaslid R., 1986) were collected at admission, in 1 hour and 3 hours after volume expanders infusion. The volume of normal saline was 20 ml/kg and of 6% HES 130/0.42 was 10 ml/kg. Results. Mean blood pressure at the 3 stages of study in response to 6% HES 130/0.42 administration was 48–55–55 mm Hg, after normal saline 51–53–49 mm Hg. Cerebral perfusion pressure after administrarion of HES 130/0.42 was 7.7–11.8–15.7 mm Hg, after normal saline 14.1–17.6–17.1 mm Hg.
Conclusions Use of HES 130/0.42 results in stable increasing of cerebral perfusion with normalizing of resistance index in front cerebral arteries. The effect occurs after administration of HES and remains up to 3–6 hours. Applying of HES 130/0.42 may be therapy of choice in low cerebral perfusion and/or hemodynamic instability in newborns with severe HIE.