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Abstract
Absolute or relative intravascular volume deficits often occur during major abdominal surgery, either because of fluid loss due to fluid shifting, evaporative loss, and surgical bleeding or vasodilatation caused by various anesthetic substances or rewarming. (1) Hypovolemia may initiate complex pathophysiological processes that may result in an inadequate tissue perfusion and decreased tissue oxygen supply. So anadequate intravascular volume replacement is essential in the management of patients undergoing major abdominal surgery.(2) Different intravascular volume replacement regimens have been proposed for providing hemodynamic stability in this situation, including blood and its components (e.g., human albumen), synthetic colloids (dextran, gelatins,hydroxyethyl starch [HES]), or crystalloids (e.g., lactated Ringer’s solution[RL])(3) Synthetic colloids have been used as plasma substitutes for more than 30 years; however, whereas no major development has occurred in relation to gelatin and dextran since they were first manufactured, hydroxyethyl starch (HES) have evolved from their introduction in the market in 1970s. The development of HES solutions has centered on designing starch molecules with an increased oncotic pressure and hemodynamic efficacy while minimizing the risk of adverse reactions such as anticoagulant effect and nephrotoxicity. (5A newly evolved HES with moderate MW and low substitution ratio 130/0..4 (6%)Voluven® has been developed to minimized the side effects whereas preserving the volume efficacy compared with older HES generation such as HES 200/0.5 (6%)Haestril.This study was aimed to compare the safety profile of Voluven with the standard colloid Haestril as regard coagulation, blood loss, transfusion requirements, and renal profile including kidney specific proteins.