Acid/base alterations during major abdominal surgery: 6% hydroxyethyl starch infusion versus 5% albumin

Kwak, Hyun Jeong; Lim, Oh Kyung; Baik, Jae Myung; Jo, Youn Yi

doi:10.4097/kja.d.18.27195

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Unexpectedly, serum Ca 2+ was significantly reduced in HES patients after surgery. This phenomenon is known, but occurs rarely and is hardly described [ 18 , 19 ]. The serum Ca 2+ level is in an equilibrium with Ca 2+ level in the cerebrum.…”

Section: Main Textmentioning

confidence: 99%

Comparison of hydroxyethylstarch (HES 130/0.4) and 5% human albumin for volume substitution in pediatric neurosurgery: A retrospective, single center study

et al. 2021

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Objective Colloid solutions are commonly used to maintain perioperative fluid homeostasis. In regard to perioperative infant-centered care, data about the impact of colloids are rare. New data suggest a possible positive effect of hydroxyethyl starch (HES) concerning blood brain barrier. Therefore we conduct a retrospective single center study of children scheduled for neurosurgery, age < five with a blood loss > 10% of body blood volume, receiving either 6% HES 130/0.4 or 5% human albumin (HA). Results Out of 913 patients, 86 were included (HES = 30; HA = 56). Compared to HES [16.4 ± 9.2 ml/kg body weight (mean ± SD)] HA group received more colloid volume (25.7 ± 11.3), which had more blood loss [HA 54.8 ± 45.0; HES 30.5 ± 30.0 (%) estimated blood volume] and higher fluid balances. Fibrinogen was decreased and activated partial thromboplastin time was elevated in HA group. Urinary output, creatinine and urea levels did not differ between the two groups. Serum calcium, total protein levels were lower in HES group. HA treated infants tended to have shorter ICU and hospital stays. We conclude that none of the investigated colloid solutions were without leverage to infants. Consequently randomized controlled trials about perioperative goal-directed fluid replacement of children undergoing (neuro)-surgery with major blood loss are needed.

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confidence: 99%

Comparison of hydroxyethylstarch (HES 130/0.4) and 5% human albumin for volume substitution in pediatric neurosurgery: A retrospective, single center study

et al. 2021

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Hyper-oncotic vs. Hypo-oncotic Albumin Solutions: a Systematic Review of Clinical Efficacy and Safety

Haynes

Bassiri²

2021

SN Compr. Clin. Med.

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Several albumin solutions are available for volume expansion. Hyper-oncotic solutions (≥ 20%) are more effective than hypo-oncotic (≤ 5%) as they recruit endogenous extracellular fluid into blood vessels rather than adding volume. The latter may cause volume overload, with several associated complications. This systematic review aimed to evaluate evidence on the efficacy and safety of hyper-oncotic vs. hypo-oncotic albumin solutions across different clinical settings. The review was conducted according to PRISMA guidelines. Ninety articles were retained (58 randomized controlled trials). Four studies directly compared albumin solutions. SWIPE showed that cumulative fluid balance at 48 h was significantly lower with 20% vs. 5% albumin (mean − 576 mL; P = 0.01). Twenty percent albumin was also associated with decreased chloride load vs. 4% albumin in critically ill patients. All 10 pre-/intraoperative studies evaluated 4–5% solutions; 14 studies evaluated 4–5% albumin in postoperative patients. Renal injury was reported in some studies; however, hydroxyethyl starch was associated with higher incidence vs. albumin. Importantly, 20% albumin preserved cumulative organ function in liver transplantation, and 25% albumin was more beneficial than saline in cardiac surgery patients. Thirty-two studies were performed in critically ill patients. Several studies reported increased risk of positive fluid balance and chloride load with hypo-oncotic albumin, whereas multiple benefits were associated with 20% albumin, including improved endothelial function and perfusion. Of 18 pediatric studies that evaluated ≤ 10% albumin, benefits such as correction of hypotension and improved cardiac output were noted. In conclusion, hyper-oncotic albumin solutions should be more routinely used to avoid potential risks associated with hypo-oncotic solutions.

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Acid/base alterations during major abdominal surgery: 6% hydroxyethyl starch infusion versus 5% albumin

Cited by 2 publications

References 24 publications

Comparison of hydroxyethylstarch (HES 130/0.4) and 5% human albumin for volume substitution in pediatric neurosurgery: A retrospective, single center study

Comparison of hydroxyethylstarch (HES 130/0.4) and 5% human albumin for volume substitution in pediatric neurosurgery: A retrospective, single center study

Hyper-oncotic vs. Hypo-oncotic Albumin Solutions: a Systematic Review of Clinical Efficacy and Safety

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