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The impact of 30 ml/kg hydroxyethyl starch 130/0.4 vs hydroxyethyl starch 130/0.42 on coagulation in patients undergoing abdominal surgery.
Indian J Med Res. 2012 Sep; 136(3):445-50.IJ

Abstract

BACKGROUND & OBJECTIVES

Hydroxyethyl starches (HES) 130/0.4 (Voluven;) and 130/0.42 (Venofundin;) impair coagulation less than older HES solutions with higher molecular weight and molar substitution. Thus, these may be used in high doses up to 50 ml/kg/day. The aim of this study was to investigate and compare the effects of HES 130/0.4 versus HES 130/0.42 on coagulation after the intraoperative infusion of 30 ml/kg in patients undergoing major abdominal surgery.

METHODS

Fifty two patients scheduled for elective major abdominal surgery were randomized to receive 30 ml/kg of HES 130/0.4 or HES 130/0.42 intraoperatively. Coagulation variables were assessed before and after infusion of the colloid solution using thrombelastography.

RESULTS

Data from 49 patients, 25 patients in the HES 130/0.4 and 24 in the HES 130/0.42 group, were analyzed. Measurements of reaction time, kinetic time, α-angle, maximum amplitude and coagulation index before and after colloid infusion did not differ between the groups. Within each group, after colloid infusion, reaction time did not change significantly, while α-angle, maximum amplitude and coagulation index values were significantly decreased (P <0.01, P<0.001 and P<0.001, respectively in HES 130/0.4 group and P<0.01, P<0.001 and P<0.01, respectively in HES 130/0.42 group). Kinetic time was significantly increased (P<0.001) in both the groups. In both groups, all thrombelastographic measurements after colloid infusion were found within normal limits.

INTERPRETATION & CONCLUSIONS

HES 130/0.4 and HES 130/0.42 showed similar, not clinically significant effects on coagulation, as assessed by thrombelastography, when a dose of 30 ml/kg was administered in patients undergoing major abdominal surgery.

Authors+Show Affiliations

Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, 76 Vassilissis Sophias Ave., Athens, Greece. c_staikou@yahoo.grNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23041738

Citation

Staikou, Chryssoula, et al. "The Impact of 30 Ml/kg Hydroxyethyl Starch 130/0.4 Vs Hydroxyethyl Starch 130/0.42 On Coagulation in Patients Undergoing Abdominal Surgery." The Indian Journal of Medical Research, vol. 136, no. 3, 2012, pp. 445-50.
Staikou C, Paraskeva A, Fassoulaki A. The impact of 30 ml/kg hydroxyethyl starch 130/0.4 vs hydroxyethyl starch 130/0.42 on coagulation in patients undergoing abdominal surgery. Indian J Med Res. 2012;136(3):445-50.
Staikou, C., Paraskeva, A., & Fassoulaki, A. (2012). The impact of 30 ml/kg hydroxyethyl starch 130/0.4 vs hydroxyethyl starch 130/0.42 on coagulation in patients undergoing abdominal surgery. The Indian Journal of Medical Research, 136(3), 445-50.
Staikou C, Paraskeva A, Fassoulaki A. The Impact of 30 Ml/kg Hydroxyethyl Starch 130/0.4 Vs Hydroxyethyl Starch 130/0.42 On Coagulation in Patients Undergoing Abdominal Surgery. Indian J Med Res. 2012;136(3):445-50. PubMed PMID: 23041738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of 30 ml/kg hydroxyethyl starch 130/0.4 vs hydroxyethyl starch 130/0.42 on coagulation in patients undergoing abdominal surgery. AU - Staikou,Chryssoula, AU - Paraskeva,Anteia, AU - Fassoulaki,Argyro, PY - 2012/10/9/entrez PY - 2012/10/9/pubmed PY - 2013/5/10/medline SP - 445 EP - 50 JF - The Indian journal of medical research JO - Indian J Med Res VL - 136 IS - 3 N2 - BACKGROUND & OBJECTIVES: Hydroxyethyl starches (HES) 130/0.4 (Voluven;) and 130/0.42 (Venofundin;) impair coagulation less than older HES solutions with higher molecular weight and molar substitution. Thus, these may be used in high doses up to 50 ml/kg/day. The aim of this study was to investigate and compare the effects of HES 130/0.4 versus HES 130/0.42 on coagulation after the intraoperative infusion of 30 ml/kg in patients undergoing major abdominal surgery. METHODS: Fifty two patients scheduled for elective major abdominal surgery were randomized to receive 30 ml/kg of HES 130/0.4 or HES 130/0.42 intraoperatively. Coagulation variables were assessed before and after infusion of the colloid solution using thrombelastography. RESULTS: Data from 49 patients, 25 patients in the HES 130/0.4 and 24 in the HES 130/0.42 group, were analyzed. Measurements of reaction time, kinetic time, α-angle, maximum amplitude and coagulation index before and after colloid infusion did not differ between the groups. Within each group, after colloid infusion, reaction time did not change significantly, while α-angle, maximum amplitude and coagulation index values were significantly decreased (P <0.01, P<0.001 and P<0.001, respectively in HES 130/0.4 group and P<0.01, P<0.001 and P<0.01, respectively in HES 130/0.42 group). Kinetic time was significantly increased (P<0.001) in both the groups. In both groups, all thrombelastographic measurements after colloid infusion were found within normal limits. INTERPRETATION & CONCLUSIONS: HES 130/0.4 and HES 130/0.42 showed similar, not clinically significant effects on coagulation, as assessed by thrombelastography, when a dose of 30 ml/kg was administered in patients undergoing major abdominal surgery. SN - 0971-5916 UR - https://www.unboundmedicine.com/medline/citation/23041738/The_impact_of_30_ml/kg_hydroxyethyl_starch_130/0_4_vs_hydroxyethyl_starch_130/0_42_on_coagulation_in_patients_undergoing_abdominal_surgery_ L2 - http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2012;volume=136;issue=3;spage=445;epage=450;aulast=Staikou DB - PRIME DP - Unbound Medicine ER -