Seventy-two hour peri-operative volume replacement with 6% HES 130/0.4 vs. 20% albumin in patients undergoing abdominal, cranial, and orthopedic surgery

Kim, Dong Hee

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2009;4(3):235-241.
Published online July 31, 2009.

Seventy-two hour peri-operative volume replacement with 6% HES 130/0.4 vs. 20% albumin in patients undergoing abdominal, cranial, and orthopedic surgery

Dong Hee Kim

Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea. ybs90@unitel.co.kr

Abstract

BACKGROUND
This study was designed to compare hydroxyethylstarch (HES) to albumin in high-risk surgery patients infused over 72 h peri-operatively; hemodynamic changes, oxygen transport parameters, blood gases, blood coagulation, blood loss, blood use, outcome, and costs were compared.
METHODS
High-risk surgical patients undergoing high-risk abdominal, cranial, and orthopaedic surgery were treated with 6% HES (130/0.4; n = 41) or 20% albumin (n = 19).The goal of volume therapy was to maintain a normal cardiac index (CI; 3.0 L/min/m2) over 72 h peri-operatively.
RESULTS
The hemodynamic and cardiac effects of 6% HES were superior to 20% albumin.HES reduced disturbances in blood coagulation, blood loss, and blood use as compared to albumin. Volume therapy with HES and albumin improved patient outcomes.Use of HES resulted in a significant cost reduction compared to albumin.
CONCLUSIONS
Volume replacement with 6% HES and 20% albumin in surgery over 72 h peri-operatively improved hemodynamic parameters and oxygen transport to normal values.HES provides a cost-effective alternative to albumin in surgery with improved efficacy and safety.

Key Words: albumin, cardiac index, high risk surgery, hydroxyethylstarch, volume replacement