Efficacy and Safety of Hydroxyethyl Starch 6% 130/0.4 in a Balanced Electrolyte Solution (Volulyte) During Cardiac Surgery

Base, Eva; Standl, Thomas; Lassnigg, Andrea; Skhirtladze, Keso; Jungheinrich, Cornelius; Gayko, Daniela; Hiesmayr, Michael

doi:10.1053/j.jvca.2010.12.005

Cited by 49 publications

(35 citation statements)

References 38 publications

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“…Thus, they do not cause excess fluid volume. 15 Therefore, to provide osmotic pressure, and reduce the fluid escape to tissue and fluid retention, fluids that have high oncotic pressure (HES, albumin, and gelatin) were selected as the priming solutions. These solutions can prevent capillary escape, which leads to fluid escape to tissue intervals, and tissue edema, which is caused by decreased oncotic pressure during CPB.…”

Section: Discussionmentioning

confidence: 99%

The Effect of HES (130/0.4) Usage as the Priming Solution on Renal Function in Children Undergoing Cardiac Surgery

et al. 2012

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Background: Experience with hydroxyethyl starch (HES) in children is limited. This study was conducted to observe the effects of HES or Ringer's lactate (RL) usage as the priming solution on renal functions in children undergoing cardiac surgery. Methods: After ethical committee approval and parent informed consent, 24 patients were included in this prospective, randomized study. During cardiopulmonary bypass (CPB), Group I received RL and Group II received HES (130/0.4) as priming solution. Serum creatinine, blood urea nitrogen (BUN), β2-microglobulin, cystatin C, and urinary albumin and creatinine, serum, and urine electrolytes were analyzed after the induction (T1), before CPB (T2), during CPB (T3), after CPB (T4), at the end of the operation (T5), on 24th hour (T6), and on 48th hour postoperatively (T7). Fractional sodium excretion (FENa), urinary albumin/creatinine ratio, and creatinine clearance were calculated. Drainage, urine output, inotropes, diuretics, and blood requirements were recorded. Results: In both the groups, β2-microglobulin was decreased during CPB and cystatin C was decreased at T3,T4, and T5 periods (p < 0.05) and the levels remained within the normal range. Creatinine clearance did not differ in the HES group, but increased in the RL group (p < 0.05). Urine albumin/creatinine ratio was increased (p < 0.05) after CPB in the HES group, and it increased at T3, T4, and T5 in the RL group (p < 0.05). There were no differences in cystatin C, β2-microglobulin, FENa, urine albumin/creatinine ratio, creatinine clearance, total fluid amount, urine output, drainage, and inotropic and diuretic requirements between the groups. Conclusion: We conclude that usage of HES (130/0.4) did not have negative effects on renal function, and it can be used as a priming solution in pediatric patients undergoing cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

The Effect of HES (130/0.4) Usage as the Priming Solution on Renal Function in Children Undergoing Cardiac Surgery

et al. 2012

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“…[57][58][59][60][61][62] In particular, hyperchloremic acidosis has been shown to reduce gastric blood flow and decrease gastric intramucosal pH in elderly surgical patients. 58 It has also been shown to reduce renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers.…”

Section: Which Fluid Should I Use?mentioning

confidence: 99%

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Miller

Roche

Mythen

2014

Can J Anesth/J Can Anesth

225

149

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Optimal perioperative fluid management is an important component of Enhanced Recovery After Surgery (ERAS) pathways. Fluid management within ERAS should be viewed as a continuum through the preoperative, intraoperative, and postoperative phases. Each phase is important for improving patient outcomes, and suboptimal care in one phase can undermine best practice within the rest of the ERAS pathway. The goal of preoperative fluid management is for the patient to arrive in the operating room in a hydrated and euvolemic state. To achieve this, prolonged fasting is not recommended, and routine mechanical bowel preparation should be avoided. Patients should be encouraged to ingest a clear carbohydrate drink two to three hours before surgery. The goals of intraoperative fluid management are to maintain central euvolemia and to avoid excess salt and water. To achieve this, patients undergoing surgery within an enhanced recovery protocol should have an individualized fluid management plan. As part of this plan, excess crystalloid should be avoided in all patients. For low-risk patients undergoing low-risk surgery, a ''zero-balance'' approach might be sufficient. In addition, for most patients undergoing major surgery, individualized goal-directed fluid therapy (GDFT) is recommended. Ultimately, however, the additional benefit of GDFT should be determined based on surgical and patient risk factors. Postoperatively, once fluid intake is established, intravenous fluid administration can be discontinued and restarted only if clinically indicated. In the absence of other concerns, detrimental postoperative fluid overload is not justified and ''permissive oliguria'' could be tolerated.Résumé La gestion périopératoire optimale des liquides est un élément important des programmes de récupération rapide après la chirurgie (RRAC). La gestion des liquides dans le cadre de la RRAC doit être vue comme un continuum au travers des phases pré-, per-et postopératoires. Chaque phase est importante pour améliorer la condition du patient et des soins sous-optimaux au cours d'une de ces phases peuvent miner les meilleures pratiques déployées tout au long de la RRAC. L'objectif de la gestion préopératoire des liquides est de faire en sorte que le patient entre en salle d'opération correctement hydraté et dans un état euvolémique. Pour y parvenir, un jeûne prolongé n'est pas recommandé et le nettoyage mécanique de l'intestin est à éviter. Les patients doivent être encouragés à absorber une boisson claire riche en hydrates de carbone, deux à trois heures avant la chirurgie. Les buts de la gestion peropératoire des liquides sont de maintenir une euvolémie centrale et d'éviter un excès de sel et d'eau. Pour y parvenir, les patients subissant une intervention chirurgicale dans le cadre d'un protocole de récupération rapide devraient avoir un programme personnalisé de gestion des liquides. Dans le cadre de ce plan, l'excès de cristalloïdes doit être évité chez tous les patients. Pour des patients à faible risque subissant une intervention c...

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“…(29) According to Stewart, the variables that contribute to the body pH are: the strong ion difference (SID, Ʃ [strong cations] -Ʃ [strong anions]), the albumin concentration, and the PCO2. (10) From this approach we can clear that the SID is the main variable to determine the metabolic influences on the body pH, so if normal saline solution or a saline based solution is infused, an increase in chloride concentration (one of the main anions) will result, leading to a decrease in the SID and hence acidosis (the so called hyperchloremic metabolic acidosis). (10) This is met with Dileep et al (21) , who in their Randomized, three-way crossover study, cleared an incidence of hyperchloremia in patients receiving NaCl containing solutions ( including: normal saline, Gelofusine and Voluven) with a direct relationship between the degree of hyperchloremia and the concentration of NaCl in the solutions used.…”

Section: Discussion:-mentioning

confidence: 99%

“…Colloids have a smaller volume of distribution than crystalloids; therefore, fewer amounts of fluid are needed to restore intravascular volume, (9) they also have been shown to improve oxygen transport, tissue oxygenation, and cardiac output. (10) Colloids have been used after cardiac surgery due to their ability to maintain intravascular volume and regional tissue perfusion more efficiently than crystalloids, (11)(12) however all intravenous fluids produce dilutional coagulopathy and colloids interact with the coagulation System (13) . Gelatins can impair coagulation (14) and affect platelet aggregation.…”

Section: …………………………………………………………………………………………………… Introduction:-mentioning

confidence: 99%

Comparative Study Between Succinylated Gelatin (Gelofusine) Versus Ringer’s Acetate Regarding Safety and Efficacy in Adult Patients Undergoing Cardiac Surgery.

Abdelhady.¹,

Elhamamssy.²,

Ali³

et al. 2017

IJAR

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Efficacy and Safety of Hydroxyethyl Starch 6% 130/0.4 in a Balanced Electrolyte Solution (Volulyte) During Cardiac Surgery

Cited by 49 publications

References 38 publications

The Effect of HES (130/0.4) Usage as the Priming Solution on Renal Function in Children Undergoing Cardiac Surgery

The Effect of HES (130/0.4) Usage as the Priming Solution on Renal Function in Children Undergoing Cardiac Surgery

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Comparative Study Between Succinylated Gelatin (Gelofusine) Versus Ringer’s Acetate Regarding Safety and Efficacy in Adult Patients Undergoing Cardiac Surgery.

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