2014
DOI: 10.1186/s13054-014-0656-0
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The impact of hydroxyethyl starches in cardiac surgery: a meta-analysis

Abstract: IntroductionRecent studies in septic patients showed that adverse effects of hydroxyethyl starches (HESs) possibly outweigh their benefits in severely impaired physiological haemostasis. It remains unclear whether this also applies to patient populations that are less vulnerable. In this meta-analysis, we evaluated the impact of various HES generations on safety and efficacy endpoints in patients undergoing cardiac surgery.MethodsWe searched the PubMed, Embase and Cochrane Central Register of Controlled Trials… Show more

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Cited by 75 publications
(84 citation statements)
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References 69 publications
(51 reference statements)
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“…23 Those results have not been added to the tables, but they are consistent with the other reviews and analyses, that is, less blood loss and transfusion with tetrastarches compared with older starches; lack of adverse safety signals for blood loss, transfusion, and length of stay versus comparators; and lesser replacement volume than with crystalloids. In addition during this period, Kancir et al 24 reported the results of a randomized blinded trial in 38 patients undergoing elective hip arthroplasty, finding no adverse renal effects of HES 130/0.4 compared with saline, as evidenced by urinary NGAL, serum creatinine, or creatinine clearance.…”
Section: Surgerysupporting
confidence: 67%
“…23 Those results have not been added to the tables, but they are consistent with the other reviews and analyses, that is, less blood loss and transfusion with tetrastarches compared with older starches; lack of adverse safety signals for blood loss, transfusion, and length of stay versus comparators; and lesser replacement volume than with crystalloids. In addition during this period, Kancir et al 24 reported the results of a randomized blinded trial in 38 patients undergoing elective hip arthroplasty, finding no adverse renal effects of HES 130/0.4 compared with saline, as evidenced by urinary NGAL, serum creatinine, or creatinine clearance.…”
Section: Surgerysupporting
confidence: 67%
“…For instance, Jacob et al 5 studied the application of tranexamic acid in surgery for congenital heart disease of infants under CPB and its effects on coagulation function and found that tranexamic acid could effectively lower postoperative blood loss and transfusion. In 2014, Haanschoten et al 6 further explored the clinical safety and effect of tranexamic acid in heart surgery through studying the effects of tranexamic acid on postoperative drainage volume, blood transfusion volume, safety, and complications in heart surgery.…”
Section: Introductionmentioning
confidence: 99%
“…These authors found that fluid resuscitation with 6% HES 130/0.4 required lower volumes to normalize blood pressure and sublingual microcirculation with a higher capillary density being recruited and more flow achieved with less volume than resuscitation with saline solution [10]. For cardiac surgery patients, the opinions are divided too, with those against the use of starches [55] and studies showing there to be no deleterious effects with the use of starches in comparison to other fluids [56]. Indeed studies have indicated that of the colloids not only starches but also gelatins [57] and even albumin administration can have adverse effects on renal function [58].…”
Section: Microcirculatory Alterations During Cardiac Surgerymentioning
confidence: 98%