The Effect of 6% Hydroxyethyl Starch 130/0.4 on Hemostasis and Hemodynamic Efficacy in Off-pump Coronary Artery Bypass Surgery: a Comparison with 6% Hydroxyethyl Starch 200/0.5.
10.4097/kjae.2007.53.3.S14
- Author:
Ji Young KIM
1
;
Jong Wha LEE
;
Tae Dong KWEON
;
Young Lan KWAK
;
Ji Ho KIM
;
Sou Ouk BANG
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. sokbang@yumc.yonsei.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
blood coagulation;
fluid therapy;
off-pump coronary artery bypass surgery;
thromboelastography
- MeSH:
Blood Coagulation;
Chest Tubes;
Coronary Artery Bypass, Off-Pump*;
Drainage;
Fluid Therapy;
Hematologic Tests;
Hemodynamics*;
Hemostasis*;
Humans;
Hypovolemia;
Intensive Care Units;
Postoperative Hemorrhage;
Starch*;
Sternum;
Thrombelastography
- From:Korean Journal of Anesthesiology
2007;53(3):S14-S21
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study was designed to compare the effect of low-molecular 6% hydroxyethyl starch (HES) 130/0.4 on hemostasis and hemodynamic efficacy with that of medium-molecular 6% HES 200/0.5 in patients undergoing off-pump coronary artery bypass surgery. METHODS: Forty-eight patients were randomized to receive up to 33 ml/kg of either 6% HES 130/0.4 or 6% HES 200/0.5. Hemodynamic variables and blood tests including thromboelastography were measured 10 min after induction (baseline value, T0), 5 min after acute loading of HES 10 ml/kg (T1) in hypovolemic patients, after sternum closure (T2), and 16 hr after intensive care unit (ICU) arrival (T3). Chest tube drainage was recorded until 16 hours after ICU arrival. RESULTS: Hemodynamic variables were similar in both groups. Chest tube drainage at 16 hr after surgery was higher in HES 200/0.5 group than that in HES 130/0.4 group. Maximum clot firmness was decreased in HES 200/0.5 group at sternal closure but not in HES 130/0.4 group. CONCLUSIONS: Both HES 200/0.5 and HES 130/0.4 were equally efficient in maintaining stable hemodynamics during off-pump coronary artery bypass surgery. However, HES 130/0.4 may reduce postoperative blood loss compared to that of HES 200/0.5 at the same dose of 33 ml/kg.
