Hydroxyethyl starch (HES) 130/0.4 reduces blood loss in off-pump coronary surgery: 010
Introduction: Post operative bleeding is attenuated in off-pump coronary artery bypass (OPCAB) but OPCAB is still associated with haemorrhagic complications and a need for blood transfusion . The new HES 130 is now available and its use is associated with less postoperative bleeding . The aim of this study was to assess the haemostatic effect of HES130 after OPCAB.
Method: Fifty two patients who had received intra and postoperatively HES 130/0.4 were compared to an historic control group of fifty two patients who had received standard HES 200/0.5. Three senior surgeons performed all procedures. Packed red blood cells were transfused when haemoglobin concentration was less than 80 g L−1. Fresh frozen plasma was given when bleeding was associated with a prothrombin time over 20 sec. Transfusion of platelets was decided in case of abnormal postoperative bleeding with a platelet count below 50 × 103 mL−1. Statistical analysis was performed with t and Χ2 test and logistic regression models.
Results: The main results are summarized in the table. Use of HES 130 was significantly associated with reduced bleeding in univariate and multivariate analysis.
Discussion: Using the HES 130 in OPCAB surgery allows a significant reduction in postoperative bleeding and a tendency to reduce exposure to blood product.
1 Cartier R. Brann S, Dagenais F, et al. Systematic off-pump coronary artery revascularization in multivessel disease: experience of three hundred cases. J Thorac Cardiovasc Surg
© 2004 European Society of Anaesthesiology
2 Gallandat Huet RC, Siemons AW, Baus D, et al. A novel hydroxyethyl starch (Voluven) for effective perioperative plasma volume substitution in cardiac surgery. Can J Anaesth