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Fast-Track/Off Pump/Prediction/Outcome

Hydroxyethyl starch (HES) 130/0.4 reduces blood loss in off-pump coronary surgery: 010

Meyer, C.; Durand, M.; Chavanon, O.; Tessier, Y.; Lefevre, M.; Blin, D.; Girardet, P.

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European Journal of Anaesthesiology: June 2004 - Volume 21 - Issue - p 21

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 [1]. The new HES 130 is now available and its use is associated with less postoperative bleeding [2]. 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.

Table
Table:
No Caption available.

Discussion: Using the HES 130 in OPCAB surgery allows a significant reduction in postoperative bleeding and a tendency to reduce exposure to blood product.

References:

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 2000; 119: 221-229.
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 2000; 47: 1207-1215.
© 2004 European Society of Anaesthesiology