TY - JOUR
T1 - Effects of intravascular volume therapy using hydroxyethyl starch (130/0.4) on post-operative bleeding and transfusion requirements in children undergoing cardiac surgery
T2 - A randomized clinical trial
AU - Chong Sung, K.
AU - Kum Suk, P.
AU - Mi Ja, Y.
AU - Kyoung Ok, K.
PY - 2006/1
Y1 - 2006/1
N2 - Background: Hydroxyethyl starch (HES) used for intravascular volume expansion may cause coagulation abnormalities, especially in cardiac patients. Although low molecular weight HES (130/0.4) has been developed to minimize its influence on coagulation, experience with HES (130/0.4) in children is limited. Therefore, we evaluated the effects of a HES (130/0.4) infusion on post-operative blood loss in children undergoing cardiac surgery. Methods: Forty-two children undergoing cardiac surgery were assigned at random to receive either 10 ml/kg fresh frozen plasma (FFP group; n = 21) or HES (130/0.4) (HES group; n = 21) shortly after cardiopulmonary bypass termination. Activated partial thromboplastin time (aPTT) and international normalization ratio (INR) were measured. In addition, post-operative transfusion requirements and blood loss until the end of the first post-operative day were compared. Results: INR was significantly prolonged after HES infusion in comparison to the FFP group (P < 0.05). During the first 24 h after surgery, post-operative blood loss, the use of allogenic blood/blood products and aPTT were similar in all children. Conclusions: Our study shows that the administration of a moderate dose of HES (130/0.4) in children undergoing cardiac surgery does not cause more bleeding or a higher transfusion requirement than a FFP infusion, and suggests that the administration of 10 ml/kg HES (130/0.4) is a safe alternative to plasma for intravascular volume replacement in this patient population.
AB - Background: Hydroxyethyl starch (HES) used for intravascular volume expansion may cause coagulation abnormalities, especially in cardiac patients. Although low molecular weight HES (130/0.4) has been developed to minimize its influence on coagulation, experience with HES (130/0.4) in children is limited. Therefore, we evaluated the effects of a HES (130/0.4) infusion on post-operative blood loss in children undergoing cardiac surgery. Methods: Forty-two children undergoing cardiac surgery were assigned at random to receive either 10 ml/kg fresh frozen plasma (FFP group; n = 21) or HES (130/0.4) (HES group; n = 21) shortly after cardiopulmonary bypass termination. Activated partial thromboplastin time (aPTT) and international normalization ratio (INR) were measured. In addition, post-operative transfusion requirements and blood loss until the end of the first post-operative day were compared. Results: INR was significantly prolonged after HES infusion in comparison to the FFP group (P < 0.05). During the first 24 h after surgery, post-operative blood loss, the use of allogenic blood/blood products and aPTT were similar in all children. Conclusions: Our study shows that the administration of a moderate dose of HES (130/0.4) in children undergoing cardiac surgery does not cause more bleeding or a higher transfusion requirement than a FFP infusion, and suggests that the administration of 10 ml/kg HES (130/0.4) is a safe alternative to plasma for intravascular volume replacement in this patient population.
KW - Cardiopulmonary bypass
KW - Children
KW - Hydroxyethyl starch
KW - Post-operative bleeding
UR - http://www.scopus.com/inward/record.url?scp=33644784087&partnerID=8YFLogxK
U2 - 10.1111/j.1399-6576.2005.00881.x
DO - 10.1111/j.1399-6576.2005.00881.x
M3 - Article
C2 - 16451158
AN - SCOPUS:33644784087
SN - 0001-5172
VL - 50
SP - 108
EP - 111
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 1
ER -