Hydroxyethyl starch 6%, 130/0.4 vs. a balanced crystalloid solution in cardiopulmonary bypass priming: a randomized, prospective study

Hasan Alper Gurbuz,Halil İbrahim Ucar,Nevriye Salman,Ahmet Baris Durukan,Elif Durukan,Murat Tavlasoglu,Cem Yorgancioglu

doi:10.1186/1749-8090-8-71

Hasan Alper Gurbuz, Halil İbrahim Ucar + Show 5 more

Open Access

https://doi.org/10.1186/1749-8090-8-71

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Abstract

BackgroundSince the advent of cardiopulmonary bypass, many efforts have been made to avoid the complications related with it. Any component of the pump participates in occurrence of these adverse events, one of which is the type of prime solution. In this study, we aimed to compare the effects of 6% hydroxyethyl starch 130/0.4 with a commonly used balanced electrolyte solution on postoperative outcomes following coronary bypass surgery.MethodsTwo hundred patients undergoing elective coronary bypass surgery were prospectively studied. The patients were randomized in to two groups. First group received a balanced electrolyte solution and the second group received 6% hydoxyethyl starch 130/0.4 as prime solution. The postoperative outcomes of the patients were studied.ResultsThe mean age of the patients was 61.81 ± 10.12 in the crystalloid group whereas 61.52 ± 9.29 in the HES group. There were 77 male patients in crystalloid group and 74 in HES group. 6% hydroxyethyl starch 130/0.4 did not have any detrimental effects on renal and pulmonary functions. The intensive care unit stay and postoperative hospital length of stay were shorter in hydroxyethyl starch group (p < 0.05 for each). Hydroxyethyl starch did not increase postoperative blood loss, amount of blood and fresh frozen plasma used, but it decreased platelet concentrate requirement. It did not have any effect on occurrence of post-coronary bypass atrial fibrillation (p > 0.05).Conclusions6% hydroxyethyl starch 130/0.4 when used as a prime solution did not adversely affect postoperative outcomes including renal functions and postoperative blood transfusion following coronary bypass surgery.

Highlights

Since the advent of cardiopulmonary bypass, many efforts have been made to avoid the complications related with it
In this randomized prospective study, we aimed to document the effects of 6% hydroxyethyl starch 130/0.4 on postoperative outcomes and occurrence of atrial fibrillation (AF) in patients undergoing on-pump coronary artery bypass grafting (CABG) surgery
We studied the effects of Hydroxyethyl starch (HES) used as a prime solution on occurrence of postoperative AF

Summary

Introduction

Since the advent of cardiopulmonary bypass, many efforts have been made to avoid the complications related with it. We aimed to compare the effects of 6% hydroxyethyl starch 130/0.4 with a commonly used balanced electrolyte solution on postoperative outcomes following coronary bypass surgery. Use of cardiopulmonary bypass (CPB), blood and constituents, various drugs and infusion of large volumes of fluids influence the renal functions. Cardiopulmonary bypass priming solution and volume are of special importance since it directly affects renal functions. Hemodilution due priming volume, continuous flow pattern of CPB, use of various drugs during CPB and occurrence of systemic inflammatory response syndrome (SIRS) adversely affect renal functions [2]. Hydroxyethyl starch (HES) is commonly used in current practice as a volume expander in trauma, shock, cardiac and other major surgeries and vast numbers of reports are being published with conflicting results. Still there is no consensus on the renal effects of HES solutions

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