Hydroxyethyl starch 130/0.42/6:1 for perioperative plasma volume replacement in 1130 children: results of an European prospective multicenter observational postauthorization safety study (PASS)

Abstract

Moderate doses of HES 130/0.42/6:1 for perioperative plasma volume replacement seem to be safe even in neonates and small infants. The probability of serious ADR is lower than 0.3%. Changes in acid-base balance may be decreased when HES is used in an acetate-containing balanced electrolyte solution instead of normal saline. Caution should be exercised in patients with renal function disturbances and those with an increased bleeding risk.

Six Percent Hydroxyethyl Starch 130/0.4 (Voluven®) versus 5% Human Serum Albumin for Volume Replacement Therapy during Elective Open-heart Surgery in Pediatric Patients

“…9 This study was one of the first to assess the effect of this tetrastarch on sensitive renal biomarkers in pediatric cardiac patients. Although high volumes of HES 130/0.4 were used, perioperative changes in these urinary renal biomarkers, as well as in plasma creatinine levels, were not different when compared with those observed with human albumin.…”

“…In addition, most of these data are obtained from low-risk population, and/or the volume of tetrastarch used was relatively low. 9,10 Further evaluation of the efficacy and safety of tetrastarches in a surgical pediatric population will require a surgical procedure associated with the use of high volumes of a colloid and a relatively high risk of complications like bleeding and renal dysfunction.…”

Perioperative Hemostasis in Pediatric Surgery

“…Besides the 'traditional' usage of albumin for pediatric fl uid resuscitation, modern synthetic colloids, e.g. gelatin solutions or hydroxyethyl starches, can be safely used even in neonates and small children (Standl et al 2008 ;Sumpelmann et al 2012 ). As with adults, the use of any synthetic or natural colloids may lead to volume-dependent changes in the hemostatic profi le and eventually to dilutional coagulopathy and occurrences of generalized microvascular oozing (Osthaus et al 2009 ;Haas et al 2012b ).…”

Schock im Kindesalter

“…Er wird in der Literatur kontrovers diskutiert [1,9,25,29] und bleibt ein spannendes Thema zukünftiger Forschung. Internationaler Standard ist eine plasmaisotone kristalloide Lösung, z.…”

“…B. Ringer-Azetat, haben den Vorteil, dass sie einen möglichst ähnlichen physiologischen Elektrolytgehalt wie das Plasma haben [25] und dass sie den Säure-Basen-und Elektrolythaushalt kaum beinträchtigen [29]. Innerklinisch kann auch die Gabe von Humanalbumin (5 %) erfolgen [1].…”