Safety and effectiveness of 6% hydroxyethyl starch 130/0.4 versus crystalloid solution for patients undergoing elective surgery：a meta-analysis
10.3760/cma.j.issn.0254-1416.2014.03.002
- VernacularTitle:6％羟乙基淀粉130/0.4与晶体液在择期手术患者中安全性及有效性的比较：m eta 分析
- Author:
Lei YANG
;
Di YANG
;
Taixiang WU
;
Jin LIU
- Publication Type:Journal Article
- Keywords:
Hetastarch;
Crystalloid;
Surgical procedures,operative;
Fluid therapy
- From:
Chinese Journal of Anesthesiology
2014;(3):261-265
- CountryChina
- Language:Chinese
-
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 patients undergoing spinal anesthesia ( P< 0.05 );there was no significant difference in the intraoperative incidence of hypotension ,perioperative incidence of nausea and vomiting ,mortality ,and intraoperative blood loss under general anesthesia or combined spinal-epidural anesthesia between the two solution groups ( P> 0.05 );heterogeneity was found in the urine output under general anesthesia ( P<0.000 01 ,I2 =93% ) .The safety and effectiveness were compared between 6% HES 130/0.4 and normal saline in 3 trials (195 patients in total) and the results showed that there was no significant difference in the intraoperative blood loss ,intraoperative incidence of hypotension ,perioperative incidence of nausea and vomiting ,coagulation function ,renal function ,and incidence of adverse events between the two solution groups ( P> 0.05 ) .Conclusion 6% HES 130/0.4 is safe and effective when applied for the patients undergoing elective surgery .
