[en] OBJECTIVES: To compare transfusion requirements in adult cardiac surgery patients when balanced hydroxyethyl starches (HES) (130/0.4) or balanced crystalloids is used for pump prime and intraoperative fluid therapy. DESIGN: Data were obtained retrospectively from medical records and perfusion charts. Matching based on propensity scores was used to adjust for potential confounders. SETTING: A university hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with the use of cardiopulmonary bypass. INTERVENTIONS: Allocation to one of the study groups according to whether balanced HES or balanced crystalloids was used for pump prime and intraoperative fluid therapy. MEASUREMENTS AND MAIN RESULTS: 240 propensity-matched patients were retained for final analyses. Forty-eight patients (40%) of the colloid group and 28 patients (23.3%) of the crystalloid group received blood products, with an odd ratio (95% CI) of 2.1(1.2-3.8 (P=0.009). After bypass HES patients had lower hemoglobin levels (8.4 [1.3] gr/dL vs 9.6 [2] gr/dL; P<0.001) and a higher cumulative chest drain output after 3 hours (180 [210] mL vs 140 [100] mL, P<0.001]. Heparinase thromboelastogram (TEG(R)) showed longer K times (2.5[1.1] vs 1.6[0.8], P<0.001) and lower maximal amplitudes (55.1[12.5] vs 63.4[9.8], P=0.008). CONCLUSIONS: HES patients required more transfusions, owing to greater hemodilution, HES-induced clotting disturbances, and bleeding.
Disciplines :
Anesthesia & intensive care
Author, co-author :
HANS, Grégory ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
LEDOUX, Didier ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs
ROEDIGER, Laurence ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anesthésie - réanimation
Hubert, Marie-Bernard ; Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
Koch, Jean-Noël ; Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
Senard, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anesthésie - réanimation
Language :
English
Title :
The effect of intraoperative 6% balanced hydroxyethyl starch (130/0.4) during cardiac surgery on transfusion requirements.
Publication date :
2015
Journal title :
Journal of Cardiothoracic and Vascular Anesthesia
ISSN :
1053-0770
eISSN :
1532-8422
Publisher :
W. B. Saunders Co., United Kingdom
Volume :
29
Issue :
2
Pages :
328-32
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2015 Elsevier Inc. All rights reserved.
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