Safety and effectiveness of 6% hydroxyethyl starch 130/0.4 versus crystalloid solution for patients undergoing elective surgery：a meta-analysis

Abstract

Objective To systematically review the safety and effectiveness of 6% hydroxyethyl starch （HES） 130/0.4 and crystalloid solution for the patients undergoing elective surgery .Methods We searched the Medline , EMBASE , CENTRAL , CNKI and Wanfang databases for randomized controlled trials involving comparison of the safety and effectiveness of 6% HES 130/0.4 and crystalloid solution for the patients undergoing elective surgery . The major evaluation indexes included intraoperative blood loss , postoperative incidence of dialysis and intraoperative incidence of hypotension . The secondary evaluation indexes included mortality , perioperative incidence of nausea and vomiting , coagulation function , renal function and incidence of adverse events .The two reviewers independently screened ,evaluated and extracted the data .Meta-analysis was performed using the Cochrane Collaboration’s RevMan 5.2 software .Results Ten trials involving 693 patients were included in our meta-analysis .Eight trials were in English and 2 trials were in Chinese .Comparison of the safety and effectiveness of 6% HES 130/0.4 and balanced solution was conducted in 7 trials （498 patients in total） ,and the results showed that 6% HES 130/0.4 reduced the intraoperative incidence of hypotension （OR 0.31 ,95% CI 0.13-0.75 ） and perioperative incidence of nausea and vomiting , （OR 0.08 , 95% CI 0.01 to 0.67 ） in the＆nbsp;patients undergoing spinal anesthesia （ P 0.05 ）;heterogeneity was found in the urine output under general anesthesia （ P 0.05 ） .Conclusion 6% HES 130/0.4 is safe and effective when applied for the patients undergoing elective surgery . Key words: Hetastarch; Crystalloid; Surgical procedures,operative; Fluid therapy