O024 / #948: DOES A BALANCED COLLOID DECREASE PERIOPERATIVE BLOOD LOSS IN PEDIATRIC CARDIAC SURGERY: A DOUBLE-BLINDED RANDOMIZED CONTROLLED TRIAL?

Abstract

Aims & Objectives: Unbalanced fluid solutions cause metabolic acidosis and could therefore be associated with impaired coagulation and increased blood loss. Our hypothesis is that the use of a balanced colloid for perioperative fluid therapy compared to a saline colloid is associated with decreased blood loss and exposure to blood products. Methods: This double blinded randomized controlled trial was conducted at a tertiary children hospital. Children older than 29 days and younger than 3 years admitted for cardiac surgery with cardiopulmonary bypass (CPB). Exclusion criteria were: emergency surgery; moribund, Jehovah witnesses, coagulopathy, renal or liver failure, intracranial hemorrhage, and electrolyte disturbances. Patients were randomly assigned to either a saline colloid (6% hydroxyethyl starch in NaCl 0.9%) or a balanced colloid (6% hydroxyethyl starch in an isotonic solution) for CPB priming and intra- and postoperative fluid therapy during the first postoperative 48 hours. Results: Eighty-nine patients were included in the study (45 in the Saline colloid and 44 in the Balanced colloid group). The primary outcome measure, calculated blood loss at postoperative day (POD3) was not significantly different between the two groups [Saline colloid: 20.7 (14.3-27.6) ml kg-1 versus Balanced colloid: 17.6 (8.6-26.0); P=0.236]. Secondary outcomes related to bleeding, exposure to blood products and coagulation were not different between groups. There was also no difference in length of mechanical ventilation, intensive care and hospital length of stay between groups. Conclusions: The use of a balanced colloid for perioperative fluid therapy compared to a saline one is not associated with decreased blood loss and exposure to blood products