Use of Intraoperative Hetastarch Priming During Coronary Bypass

Canver, Charles C.; Nichols, Ronald

doi:10.1378/chest.118.6.1616

Cited by 20 publications

(6 citation statements)

References 11 publications

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“…[30] compared volume replacement with gelatin and LMW-HES 130/0.4; there were no significant differences between the two groups indicating that this LMW-HES 130/0.4 can be safely used in cardiac surgery. All these studies[31‐33] were done in patients scheduled for CABG using the conventional CPB where several other mechanisms related to CPB can be responsible for derangement of coagulation. In our study the deleterious effects of CPB are avoided and it was found that HES with higher molecular weight and degree of substitution cause more impairment of coagulation system.…”

Section: Discussionmentioning

confidence: 99%

Influence of colloid infusion on coagulation during off-pump coronary artery bypass grafting

Kanchi

Garg²,

Mohanty³

et al. 2010

Indian J Anaesth

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This study was conducted to determine the influence of colloid infusion on coagulation in patients undergoing off-pump coronary artery bypass grafting (OP-CABG). Thirty patients undergoing elective OP-CABG received medium molecular weight hydroxyethyl starch group I (MMW-HES 200/0.5), low molecular weight hydroxyethyl starch group II (LMW-HES 130/0.4) or gelatin group III (GEL) in a prospective randomized trial. Blood samples were assessed for hemoglobin (Hb), activated coagulation time (ACT), prothrombin time (PT), activated partial thromboplastin time (aPPT), platelet count, fibrinogen and von Willebrand factor (vWF) at specified intervals. Total volume of the colloid infused and postoperative chest-time drainage was also measured. There was a significant decrease in Hb, platelet count, fibrinogen levels in all these groups, which did not warrant blood transfusion. After the colloid infusion, vWF decreased significantly to 67% from baseline in group I as compared to 85 and 79% in group II and group III, respectively. vWF levels remained lower than the baseline value in the first 24 hours in group I, whereas this factor level increased above the baseline values in groups II and III, 6 hours postoperatively. Postoperative chest tube drainage in 24 hours was significantly higher in group I (856 ± 131 ml) as compared to group II (550 ± 124 ml) and group III (582 ± 159 ml). LMW-HES 130/0.4 was superior to MMW-HES 200/0.5 and gelatin in patients undergoing OP-CABG, in terms of better preservation of coagulation associated with enhanced volume effect.

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Section: Discussionmentioning

confidence: 99%

Influence of colloid infusion on coagulation during off-pump coronary artery bypass grafting

Kanchi

Garg²,

Mohanty³

et al. 2010

Indian J Anaesth

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“…The most common choice for prime solution have been RL, albumin, HES, and polygeline. Although it was reported that HES, as a prime solution in open heart surgery was more effective regarding its cardiac and systemic effects [5,6] , there are less studies in the literature that monitored cerebral functions. Iriz et al reported that HES is a better prime solution than RL [7] .…”

Section: Resultsmentioning

confidence: 99%

Comparison of Kabilyte? and Ringer Lactate as Prime Solution on Cognitive Functions in Patients Undergoing Cardiopulmonary Bypass

2017

IJSR

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Central nervous system dysfunction remains a major cause of morbidity and mortality after cardiac surgical procedures done on cardiopulmonary bypass. A novel brand of balanced salt solution, kabilyte ® and Ringer lactate (RL) were used as prime solutions in the present study.We aim to compare the cerebral protective effects of kabilyte ® and ringer lactate solutions in CPB using Mini Mental State Examination tests. Method: Patients were randomized into two groups. Open heart surgery was performed by using kabilyte ® in group A (n ꞊ 32) and Ringer lactate solution in group B (n ꞊ 32). Preoperative and postoperative informative cognitive test scores, characteristics of the patients were compared. Results: No significant difference was found between the preoperative and postoperative cognitive test scores in group A as well as Group B (p ≥ 0.05). Conclusion:It may be suggested that Kabilyte ® as well as RL may cause a reduction in the incidence of cerebral complications when used as prime solution in patients who undergo CPB.

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“…The prospective clinical data regarding the use of HES in cardiac surgery is controversial with respect to blood loss and allogeneic blood transfusions. Similar to retrospective studies, many of these studies were performed with Hespan and not HEX 14,17‐20 . Kuitunen and coworkers 18 compared high‐ and low‐molecular‐weight HES (20 mL/kg) with albumin as the main component of the CPB priming solution and observed that while HES solutions were associated with abnormalities in thromboelastographic variables, there was no difference in transfusion requirements among the groups 18 .…”

Section: Discussionmentioning

confidence: 99%

Postoperative blood loss and transfusion associated with use of Hextend in cardiac surgery patients at a blood conservation center

Moskowitz¹,

Shander²,

Javidroozi³

et al. 2008

Transfusion

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Although HEX was associated with transfusion in univariate analysis and with CTD in uni- and multivariate analysis, the former was no longer significant when adjusted for other predictors of transfusion in our selected patient population at a blood conservation center. The clinical significance of the observed increase in CTD remains undetermined. To minimize transfusion and bleeding in these patients, it is recommended that HEX be used in amounts of not more than 20 mL per kg together with point-of-care coagulation tests and other blood conservation strategies.

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Use of Intraoperative Hetastarch Priming During Coronary Bypass

Cited by 20 publications

References 11 publications

Influence of colloid infusion on coagulation during off-pump coronary artery bypass grafting

Influence of colloid infusion on coagulation during off-pump coronary artery bypass grafting

Comparison of Kabilyte? and Ringer Lactate as Prime Solution on Cognitive Functions in Patients Undergoing Cardiopulmonary Bypass

Postoperative blood loss and transfusion associated with use of Hextend in cardiac surgery patients at a blood conservation center

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