ObjectiveThe aim of this study was to compare the effect of 6% hydroxyl ethyl starch solution with 4% gelatin and Ringer’s solutions on the haemodynamic stability of patients after coronary artery bypass graft (CABG) surgery and immediately after discontinuation of cardiopulmonary bypass (CPB).MethodsThis was a randomised, double-blind clinical trial of 92 patients who were candidates for on-pump CABG. After discontinuation of CPB, all patients were transferred to the intensive care unit (ICU) and divided randomly into three groups. The first group received Ringer’s solution, the second group 4% gelatin, and the third 6% hydroxyl ethyl starch (HES) solution (Voluven). Haemodynamic parameters such as heart rate, mean arterial pressure, systolic blood pressure, diastolic blood pressure, central venous pressure, cardiac output and the presence of arrhythmias were documented.ResultsThe volume needed for maintaining normal blood pressure and central venous pressure in the range of 10–14 mmHg was less in the HES group than in the other groups. The volume was similar however in the gelatin and Ringer’s groups in the first 24 hours after surgery. Urinary output in the first four and 24 hours after surgery were significantly higher in the HES group than in the other two groups. Mean creatinine levels were significantly lower in the HES group.ConclusionHES (6%) had a better volume-expanding effect than gelatin (4%) and Ringer’s solutions, and its short-term effects on renal function were also better than gelatin and Ringer’s solutions.

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Objectives: The current study tries to assess the causative factors of dysphagia and omit them to find the exact contribution of TEE for this symptom among patients who suffer from elective open cardiac surgery in different age ranges in both sexes. Methods: In this observational study, 100 patients between 30-80 years of age with ASA < III and EF > 40% who were candidate for elective open cardiac surgery in a referral hospital in Tehran in 2011 were recruited. The patients were divided into two groups based on TEE performance; patients who needed to perform TEE based on medical indication were considered the case group and the other patients who did not have indication for TEE, formed the control group. Results: Total frequency of dysphagia was 13% in all patients disregarding TEE performance while 6 (12%) and 7 (14%) of controls and cases showed this symptom respectively. Odynophagia was the other symptom to be assessed for its frequency in this study and showed 13% total frequency considering all participants disregarding the groups. This symptom was reported exactly similar to dysphagia which was 6 (12%) in controls and 7 (14%) in cases. The participants' gender was not effective on the distribution of dysphagia where 6 (11.3%) females and 7 (14.9%) males were involved with no significant difference. Conclusions: Intraoperative trans-esophageal echocardiography during cardiac surgeries has greater usefulness than complications and is worth using in this case as well.