Abstract | BACKGROUND: Hydroxyethyl starch (HES) used for intravascular volume expansion may cause coagulation abnormalities, especially in cardiac patients. Although low molecular weight HES (130/0.4) has been developed to minimize its influence on coagulation, experience with HES (130/0.4) in children is limited. Therefore, we evaluated the effects of a HES (130/0.4) infusion on post-operative blood loss in children undergoing cardiac surgery. METHODS: Forty-two children undergoing cardiac surgery were assigned at random to receive either 10 ml/kg fresh frozen plasma (FFP group; n=21) or HES (130/0.4) (HES group; n=21) shortly after cardiopulmonary bypass termination. Activated partial thromboplastin time (aPTT) and international normalization ratio (INR) were measured. In addition, post-operative transfusion requirements and blood loss until the end of the first post-operative day were compared. RESULTS: INR was significantly prolonged after HES infusion in comparison to the FFP group (P<0.05). During the first 24 h after surgery, post-operative blood loss, the use of allogenic blood/blood products and aPTT were similar in all children. CONCLUSIONS: Our study shows that the administration of a moderate dose of HES (130/0.4) in children undergoing cardiac surgery does not cause more bleeding or a higher transfusion requirement than a FFP infusion, and suggests that the administration of 10 ml/kg HES (130/0.4) is a safe alternative to plasma for intravascular volume replacement in this patient population.
|
Authors | K Chong Sung, P Kum Suk, Y Mi Ja, K Kyoung Ok |
Journal | Acta anaesthesiologica Scandinavica
(Acta Anaesthesiol Scand)
Vol. 50
Issue 1
Pg. 108-11
(Jan 2006)
ISSN: 0001-5172 [Print] England |
PMID | 16451158
(Publication Type: Journal Article, Randomized Controlled Trial)
|
Chemical References |
- Hydroxyethyl Starch Derivatives
- Plasma Substitutes
|
Topics |
- Blood Transfusion
- Cardiac Surgical Procedures
- Cardiopulmonary Bypass
- Child
- Child, Preschool
- Heart Defects, Congenital
(surgery)
- Humans
- Hydroxyethyl Starch Derivatives
(administration & dosage)
- Infant
- International Normalized Ratio
- Molecular Weight
- Partial Thromboplastin Time
- Plasma
- Plasma Substitutes
(administration & dosage)
- Postoperative Care
- Postoperative Hemorrhage
(therapy)
|