Abstract
Objective: This study aimed to compare the resuscitation effect of Ringer’s lactate (RL) and the combination of Ringer’s lactate/6% hydroxyethyl starch (HES) (130/0.4) with a ratio 2:1 (RLH) on plasma syndecan-1 (synd-1) level as a marker of endothelial glycocalyx (EG) degradation in patients with hemorrhagic shock (HS).
Design: This prospective, experimental, analytic study with a single-blind trial design assessed the resuscitation effect of RL compared to RLH on the synd-1 level as a marker of EG degradation in patients with HS.
Setting: We conducted this study in the operating room (OR) and the Intensive Care Unit (ICU) of Wahidin Sudirohusodo Hospital and Hasanuddin University Medical Research Center (HUMRC) from September 2022 to February 2023.
Patients and participants: The patients underwent elective surgery with estimated HS class II and III.
Intervention: The patients in the RL group were resuscitated with RL solution, and those in the RLH group were resuscitated with the RLH solution. The blood sample was collected to measure the synd-1 level.
Measurement and results: The synd-1 level increased after HS. After resuscitation, the synd-1 level decreased in both groups at 6 and 24 hours in HS class II and 6 hours in HS class III, yet increased at 24 hours in HS class III. There was no significant difference between the two groups. However, the decrease in synd-1 level in the RLH group was higher than in the RL group, and the increase in synd-1 level in the RLH group was lower than in the RL group.
Conclusion: The resuscitation effect of RL and RLH solution did not suggest a significant difference in improving the synd-1 level as a marker of EG degradation in HS. However, resuscitation with RLH solution provided a better profile of synd-1 level than RL.
Rezki Hardiyanti, Faisal Muchtar, Syafri Kamsul Arif, Ari Santri Palinrungi, Haizah Nurdin
