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RETRACTED ARTICLE

Comparison of the effects of gelatin and a modern hydroxyethyl starch solution on renal function and inflammatory response in elderly cardiac surgery patients.
Br J Anaesth 2008; 100(4):457-64BJ

Abstract

BACKGROUND

The effects of hydroxyethylstarch (HES) 130/0.4 6% and gelatin 4% on inflammation, endothelial integrity, and renal function after cardiac surgery were compared.

METHODS

Sixty patients aged >80 yr undergoing cardiac surgery were randomized to receive gelatin (n=30) or HES 130/0.4 (n=30). The colloid was used in the priming of the cardiopulmonary bypass circuit (500 ml) and for volume replacement until the second postoperative day (POD). Serum creatinine, creatinine clearance, IL-6, IL-10, intercellular adhesion molecule-1 (sICAM-1), urinary glutathione transferase-alpha, and neutrophil gelatinase-associated lipocalin (NGAL) were measured perioperatively. Serum creatinine was also reported approximately 60 days after discharge.

RESULTS

The mean(sd) volume of gelatin infused was 4180(440) ml, which was greater than the volume of HES infused 2910(330) ml (P=0.002). The mean(sd) volume of serum creatinine on the first POD was 151(24) micromol litre(-1) in the gelatin group and 126(13) micromol litre(-1) in the HES group (P=0.004). Values for the second POD were 161(0.26) and 133(16) micromol litre(-1), respectively (P=0.004). Creatinine clearance was lower in the gelatin group on the first POD [37(7) vs 46(8) ml min(-1) 1.73 m2 (P=0.004)] and the second POD [32(8) vs 45(10) ml min(-1) 1.73 m2 (P=0.002)]. Kidney function approximately 60 days after discharge did not differ between the groups. IL-6, IL-10, and sICAM-1 were significantly lower in the HES group than in the gelatin group on the first and second PODs. Urinary alpha-GST increased in both groups to a comparable extent. Urinary NGAL concentrations were higher in the gelatin than in the HES patients 5 h after surgery and on the first and second PODs.

CONCLUSIONS

In cardiac surgery patients aged >80 years, volume therapy with HES 130/0.4 6% was associated with less marked changes in kidney function and a less marked endothelial inflammatory response than gelatin 4%.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, D-67063 Ludwigshafen, Germany. boldtj@gmx.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

18305082

Citation

Boldt, J, et al. "Comparison of the Effects of Gelatin and a Modern Hydroxyethyl Starch Solution On Renal Function and Inflammatory Response in Elderly Cardiac Surgery Patients." British Journal of Anaesthesia, vol. 100, no. 4, 2008, pp. 457-64.
Boldt J, Brosch Ch, Röhm K, et al. Comparison of the effects of gelatin and a modern hydroxyethyl starch solution on renal function and inflammatory response in elderly cardiac surgery patients. Br J Anaesth. 2008;100(4):457-64.
Boldt, J., Brosch, C. h., Röhm, K., Papsdorf, M., & Mengistu, A. (2008). Comparison of the effects of gelatin and a modern hydroxyethyl starch solution on renal function and inflammatory response in elderly cardiac surgery patients. British Journal of Anaesthesia, 100(4), pp. 457-64. doi:10.1093/bja/aen016.
Boldt J, et al. Comparison of the Effects of Gelatin and a Modern Hydroxyethyl Starch Solution On Renal Function and Inflammatory Response in Elderly Cardiac Surgery Patients. Br J Anaesth. 2008;100(4):457-64. PubMed PMID: 18305082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the effects of gelatin and a modern hydroxyethyl starch solution on renal function and inflammatory response in elderly cardiac surgery patients. AU - Boldt,J, AU - Brosch,Ch, AU - Röhm,K, AU - Papsdorf,M, AU - Mengistu,A, Y1 - 2008/02/27/ PY - 2008/2/29/pubmed PY - 2008/4/16/medline PY - 2008/2/29/entrez SP - 457 EP - 64 JF - British journal of anaesthesia JO - Br J Anaesth VL - 100 IS - 4 N2 - BACKGROUND: The effects of hydroxyethylstarch (HES) 130/0.4 6% and gelatin 4% on inflammation, endothelial integrity, and renal function after cardiac surgery were compared. METHODS: Sixty patients aged >80 yr undergoing cardiac surgery were randomized to receive gelatin (n=30) or HES 130/0.4 (n=30). The colloid was used in the priming of the cardiopulmonary bypass circuit (500 ml) and for volume replacement until the second postoperative day (POD). Serum creatinine, creatinine clearance, IL-6, IL-10, intercellular adhesion molecule-1 (sICAM-1), urinary glutathione transferase-alpha, and neutrophil gelatinase-associated lipocalin (NGAL) were measured perioperatively. Serum creatinine was also reported approximately 60 days after discharge. RESULTS: The mean(sd) volume of gelatin infused was 4180(440) ml, which was greater than the volume of HES infused 2910(330) ml (P=0.002). The mean(sd) volume of serum creatinine on the first POD was 151(24) micromol litre(-1) in the gelatin group and 126(13) micromol litre(-1) in the HES group (P=0.004). Values for the second POD were 161(0.26) and 133(16) micromol litre(-1), respectively (P=0.004). Creatinine clearance was lower in the gelatin group on the first POD [37(7) vs 46(8) ml min(-1) 1.73 m2 (P=0.004)] and the second POD [32(8) vs 45(10) ml min(-1) 1.73 m2 (P=0.002)]. Kidney function approximately 60 days after discharge did not differ between the groups. IL-6, IL-10, and sICAM-1 were significantly lower in the HES group than in the gelatin group on the first and second PODs. Urinary alpha-GST increased in both groups to a comparable extent. Urinary NGAL concentrations were higher in the gelatin than in the HES patients 5 h after surgery and on the first and second PODs. CONCLUSIONS: In cardiac surgery patients aged >80 years, volume therapy with HES 130/0.4 6% was associated with less marked changes in kidney function and a less marked endothelial inflammatory response than gelatin 4%. SN - 1471-6771 UR - https://www.unboundmedicine.com/medline/citation/18305082/Comparison_of_the_effects_of_gelatin_and_a_modern_hydroxyethyl_starch_solution_on_renal_function_and_inflammatory_response_in_elderly_cardiac_surgery_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)34361-1 DB - PRIME DP - Unbound Medicine ER -