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Volume replacement therapy during major orthopedic surgery using Voluven (hydroxyethyl starch 130/0.4) or hetastarch.
Anesthesiology. 2007 Jun; 106(6):1120-7.A

Abstract

BACKGROUND

The purpose of this study was to test the equivalence of efficacy and compare the safety of the 6% hydroxyethyl starches (HES) Voluven (HES 130/0.4; Fresenius Kabi, Bad Homburg, Germany) and hetastarch (HES 670/0.75 in saline) for intravascular volume replacement therapy during major orthopedic surgery.

METHODS

In a prospective, controlled, randomized, double-blind, multicenter trial of patients undergoing major orthopedic surgery, 49 patients were treated with HES 130/0.4 and 51 patients were treated with hetastarch. Infusion of colloids was guided by central venous and arterial blood pressures. The primary efficacy endpoint was the volume of colloid solution infused; the primary safety endpoints were calculated total erythrocyte loss, the nadir factor VIII activity, and the nadir von Willebrand factor concentration within 2 h of completion of surgery.

RESULTS

The total volume of colloid solution required for intraoperative volume replacement did not differ between HES 130/0.4 and hetastarch (1,613+/-778 [SD] ml for HES 130/0.4 and 1,584+/-958 ml for hetastarch). The nadir factor VIII activity within 2 h of the end of surgery was lower for hetastarch than for HES 130/0.4 (P=0.0499); for those who received greater than 1,000 ml colloid, the nadir factor VIII activity and von Willebrand factor concentration within 2 h of end of surgery were lower for hetastarch than for HES 130/0.4 (P=0.0487 and P=0.008, respectively).

CONCLUSION

Voluven (HES 130/0.4) and hetastarch are equally efficacious plasma volume substitutes; however, HES 130/0.4 has a lesser effect on coagulation.

Authors+Show Affiliations

Department of Anesthesiology, Clement J. Zablocki Veterans Affairs Medical Center and the Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. sdgandhi@mcw.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17525586

Citation

Gandhi, Sweeta D., et al. "Volume Replacement Therapy During Major Orthopedic Surgery Using Voluven (hydroxyethyl Starch 130/0.4) or Hetastarch." Anesthesiology, vol. 106, no. 6, 2007, pp. 1120-7.
Gandhi SD, Weiskopf RB, Jungheinrich C, et al. Volume replacement therapy during major orthopedic surgery using Voluven (hydroxyethyl starch 130/0.4) or hetastarch. Anesthesiology. 2007;106(6):1120-7.
Gandhi, S. D., Weiskopf, R. B., Jungheinrich, C., Koorn, R., Miller, D., Shangraw, R. E., Prough, D. S., Baus, D., Bepperling, F., & Warltier, D. C. (2007). Volume replacement therapy during major orthopedic surgery using Voluven (hydroxyethyl starch 130/0.4) or hetastarch. Anesthesiology, 106(6), 1120-7.
Gandhi SD, et al. Volume Replacement Therapy During Major Orthopedic Surgery Using Voluven (hydroxyethyl Starch 130/0.4) or Hetastarch. Anesthesiology. 2007;106(6):1120-7. PubMed PMID: 17525586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Volume replacement therapy during major orthopedic surgery using Voluven (hydroxyethyl starch 130/0.4) or hetastarch. AU - Gandhi,Sweeta D, AU - Weiskopf,Richard B, AU - Jungheinrich,Cornelius, AU - Koorn,Robert, AU - Miller,Diane, AU - Shangraw,Robert E, AU - Prough,Donald S, AU - Baus,Daniela, AU - Bepperling,Frank, AU - Warltier,David C, PY - 2007/5/26/pubmed PY - 2007/6/29/medline PY - 2007/5/26/entrez SP - 1120 EP - 7 JF - Anesthesiology JO - Anesthesiology VL - 106 IS - 6 N2 - BACKGROUND: The purpose of this study was to test the equivalence of efficacy and compare the safety of the 6% hydroxyethyl starches (HES) Voluven (HES 130/0.4; Fresenius Kabi, Bad Homburg, Germany) and hetastarch (HES 670/0.75 in saline) for intravascular volume replacement therapy during major orthopedic surgery. METHODS: In a prospective, controlled, randomized, double-blind, multicenter trial of patients undergoing major orthopedic surgery, 49 patients were treated with HES 130/0.4 and 51 patients were treated with hetastarch. Infusion of colloids was guided by central venous and arterial blood pressures. The primary efficacy endpoint was the volume of colloid solution infused; the primary safety endpoints were calculated total erythrocyte loss, the nadir factor VIII activity, and the nadir von Willebrand factor concentration within 2 h of completion of surgery. RESULTS: The total volume of colloid solution required for intraoperative volume replacement did not differ between HES 130/0.4 and hetastarch (1,613+/-778 [SD] ml for HES 130/0.4 and 1,584+/-958 ml for hetastarch). The nadir factor VIII activity within 2 h of the end of surgery was lower for hetastarch than for HES 130/0.4 (P=0.0499); for those who received greater than 1,000 ml colloid, the nadir factor VIII activity and von Willebrand factor concentration within 2 h of end of surgery were lower for hetastarch than for HES 130/0.4 (P=0.0487 and P=0.008, respectively). CONCLUSION: Voluven (HES 130/0.4) and hetastarch are equally efficacious plasma volume substitutes; however, HES 130/0.4 has a lesser effect on coagulation. SN - 0003-3022 UR - https://www.unboundmedicine.com/medline/citation/17525586/Volume_replacement_therapy_during_major_orthopedic_surgery_using_Voluven__hydroxyethyl_starch_130/0_4__or_hetastarch_ L2 - https://pubs.asahq.org/anesthesiology/article-lookup/doi/10.1097/01.anes.0000265422.07864.37 DB - PRIME DP - Unbound Medicine ER -