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Effects of intravascular volume therapy using hydroxyethyl starch (130/0.4) on post-operative bleeding and transfusion requirements in children undergoing cardiac surgery: a randomized clinical trial.

AbstractBACKGROUND:
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.
AuthorsK Chong Sung, P Kum Suk, Y Mi Ja, K Kyoung Ok
JournalActa anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 50 Issue 1 Pg. 108-11 (Jan 2006) ISSN: 0001-5172 [Print] England
PMID16451158 (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)

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