Hydroxyethyl Starch 130/0.4 Versus Modified Fluid Gelatin for Volume Expansion in Cardiac Surgery Patients: The Effects on Perioperative Bleeding and Transfusion Needs

Linden, Philippe J. Van der; Hert, Stefan De; Deraedt, Dirk; Cromheecke, S.; Decker, Koen De; Paep, Rudi De; Rodrigus, Inez; Daper, Anne; Trenchant, Anne

doi:10.1213/01.ane.0000175216.53374.27

Cited by 111 publications

(76 citation statements)

References 24 publications

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“…The similar effect of HES 130/0.4 and gelatin on postoperative blood loss has already been demonstrated (Van der Linden et al 2005). Moreover, the modern HES and gelatin solutions have been proven safe regarding bleeding in comparison with Ringer's or albumin solutions (Tigchelaar et al 1997, Boldt et al 2009).…”

Section: Blood Loss and Fluid Balancementioning

confidence: 68%

“…Several clinical studies have reported similar blood loss and use of blood products after infusion of gelatin or HES 130/0.4 solutions after cardiac surgery (Van der Linden et al 2005. The effect of gelatin is slight, without any evidence of increased blood loss perioperatively.…”

Section: Coagulation Effects Of Gelatinmentioning

confidence: 86%

“…High-MW HES solutions cause increased bleeding after cardiac surgery (Cope et al 1997). The impact of rapidly degradable HES solutions of low MW (i.e., HES 130/0.4) on postoperative blood loss is minimal or absent (Van der Linden et al 2005), although laboratory analysis has revealed some negative effects (Felfernig et al 2003). The effect of gelatin on blood coagulation is controversial.…”

Section: Introductionmentioning

confidence: 99%

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Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

Schramko¹

2011

Acta Anaesthesiol Scand

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Section: Blood Loss and Fluid Balancementioning

confidence: 68%

Section: Coagulation Effects Of Gelatinmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

Schramko¹

2011

Acta Anaesthesiol Scand

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“…Niemi and colleagues [8] reported that the greatest impairment of coagulation was seen with HES. However, the newer starch formulation of 6% HES 130/0.4 has been shown to be safe and comparable to gelatin-based colloids in cardiac surgery [9,10]. In the present study we compare 4% succinylated gelatin with 6% hydroxyethyl starch 130/0.4 for preloading prior to cardiopulmonary bypass in coronary artery bypass grafting patients with respect to haemodynamics status, blood loss, transfusion requirement, ICU stay and complication.…”

Section: Discussionmentioning

confidence: 98%

Comparison of 4% Succinylated Gelatin with 6% Hydroxyethyl Starch 130/0.4 for Preloading Prior to Cardiopulmonary Bypass in Coronary Artery Bypass Grafting Patients

Deshmukh

Dave

Gujjar

2016

Int J of Biomed & Adv Res

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Aims and Objective: The present study was carried out with an objective to compare 4% succinylated gelatin with 6% hydroxyethyl starch 130/0.4 for preloading prior to cardiopulmonary bypass in coronary artery bypass grafting patients with respect to haemodynamics status, blood loss, transfusion requirement, ICU stay and complication. Methods: The study enrolling 60 patients of either sex, aged between 30-70 years undergoing elective coronary artery bypass grafting. These patients were randomly divided into two groups of 30 each. Group 1 received 500 ml 6% hydroxyethyl starch (HES) and group 2 received 500 ml 4% succinylated gelatins, on pump over a period of 25 minutes. Data were monitored included haemodynamic changes, postoperative blood loss, transfusion of PRBC and blood products, ICU stay and complications related to colloid usage. Results: We found statistically significant difference in pulse rate 5 minutes after starting colloid. Also found statistically significant difference in mean arterial pressure immediately after shifting patient to ICU but no significant difference found subsequently. There was gradual increase in CVP in both the groups but majority of patients in group 2 showed higher CVP values as compared to group 1 patients. Measured chest tube drain and output higher in starch group as compared to gelatin group, there was no need of reexploration or greater need for blood and blood products in starch group. There was no significant difference in postoperative renal parameter between two groups. Conclusions: Results of our study revealed that both the colloids i.e. 4% succinylated gelatin and 6% hydroxyethyl starch were comparable with respect to haemodynamics parameters, blood loss, transfusion requirement and complication.

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“…70 ml/kg) were infused in trauma patients during initial resuscitation. Further studies confirm the safe use of 6% HES 130/0.4 [17][18][19][20].…”

Section: In Patients Undergoingmentioning

confidence: 94%

The Volume Effect and Safety of 6% Hydroxyethyl Starch 130/0.4 in Patients Undergoing Major Elective Surgery: An Uncontrolled, Open-Labeled, Multi-Center Study

Morioka¹,

Ozaki²,

Yamakage³

et al. 2013

OJAnes

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Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need to infuse human albumin may be reduced or avoided in Japan if these large doses 6% HES 130/0.4 can be infused. Methods: The study was an uncontrolled, open-labeled, multi-center trial. Fifteen adult and 5 pediatric patients undergoing major elective surgery received 6% HES 130/0.4 (Voluven ® ) with a maximum dose of 50 mL/kg from the start of surgery until 2 hours after the end of surgery according to a treatment algorithm. The primary efficacy endpoint was the volume effect of 6% HES 130/0.4 determined by the volume of saved albumin during the investigational period and the time course of hemodynamic stability in adult and pediatric patients. Safety parameters were fluid balance, hemodynamic and laboratory parameters ECG, local and systemic tolerance and adverse events. Results: Adult patients received a mean of 32.0 mL/kg of 6% HES 130/0.4. For 12 out of 15 adult patients an average amount of 1033.8 mL (18.6 mL/kg) albumin could be saved. The other 3 adult patients did not receive more than 1000 mL of HES 130/0.4. All pediatric patients received approximately 50 mL/kg of HES 130/0.4; for these patients an average amount of 39.9 mL/kg body weight albumin could be saved. The majority of adult patients, and all pediatric patients were hemodynamically stable at all 3 time points. The observed changes of the assessed laboratory parameters including hematological and coagulation parameters or in any other safety parameter determined did not reveal any safety concern related to the administration of 6% HES 130/0.4 up to doses of 50 mL/kg body weight. Conclusion: The study results indicate that 6% HES 130/0.4 has a reliable volume effect, could contribute to significant human albumin savings and was safe and well tolerated up to a maximum dose of 50 mL/kg body weight in adult and pediatric patients undergoing major elective surgery.

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Hydroxyethyl Starch 130/0.4 Versus Modified Fluid Gelatin for Volume Expansion in Cardiac Surgery Patients: The Effects on Perioperative Bleeding and Transfusion Needs

Cited by 111 publications

References 24 publications

Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

Comparison of 4% Succinylated Gelatin with 6% Hydroxyethyl Starch 130/0.4 for Preloading Prior to Cardiopulmonary Bypass in Coronary Artery Bypass Grafting Patients

The Volume Effect and Safety of 6% Hydroxyethyl Starch 130/0.4 in Patients Undergoing Major Elective Surgery: An Uncontrolled, Open-Labeled, Multi-Center Study

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