Comparing the effects of 5% albumin and 6% hydroxyethyl starch 130/0.4 on coagulation and inflammatory response when used as priming solutions for cardiopulmonary bypass

Y. S. Choi, J. K. Shim, S. W. Hong, J. C. Kim, Y. L. Kwak

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Abstract

Aim. This prospective, randomized and controlled trial compares the use of human albumin (HA) and hydroxyethyl starch (HES) 130/0.4 in the priming solution for a non-biocompatible cardiopulmonary bypass (CPB) circuit. The effects of each substance on coagulation, postoperative blood loss and pro-inflammatory activities were examined. Methods. Thirty-six adult patients undergoing mitral valvular heart surgery were randomly assigned to either the HA or HES group; 500 mL of 5% HA or 6% HES 130/0.4 were added to the priming solution of the CPB circuit for each group, respectively. Coagulation variables were measured perioperatively; these variables included thromboelastographic (TEG) parameters and pro-inflammatory markers such as interleukin (IL)-6, IL-8 and tumor necrotic factor (TNF)-α. Postoperative blood loss and transfusion requirements were also assessed. Results. There were no significant intergroup differences in the coagulation variables (including TEG parameters), serum concentrations of IL-6, IL-8 and TNF-α, and blood loss or transfusion requirements. TEG parameters, which indicate the speed of solid clot formation and the strength of the fibrin clot, decreased up to 4 hours after CPB in both groups. Serum concentrations of IL-6, IL-8 and TNF-α were higher up to 12 hours after surgery compared to baseline values in both groups. Hemoglobin levels and platelet counts were lower up to 12 hours after surgery compared to baseline values in both groups. Conclusion. HES 130/0.4 was comparable to albumin as a component of the priming solution for a non-biocompatible CPB circuit. The two substances showed similar effects on coagulation variables, blood loss and pro-inflammatory activities in adult patients undergoing mitral valvular heart surgery.

Original languageEnglish
Pages (from-to)584-591
Number of pages8
JournalMinerva anestesiologica
Volume76
Issue number8
Publication statusPublished - 2010 Aug 1

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Hydroxyethyl Starch Derivatives
Cardiopulmonary Bypass
Albumins
Interleukin-8
Postoperative Hemorrhage
Interleukin-6
Thoracic Surgery
Neoplasms
Blood Coagulation
Fibrin
Serum
Platelet Count
Blood Transfusion
Starch
Hemoglobins
Randomized Controlled Trials

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

@article{d8d5e48e5a73473d8e115d10a3b3c55d,
title = "Comparing the effects of 5{\%} albumin and 6{\%} hydroxyethyl starch 130/0.4 on coagulation and inflammatory response when used as priming solutions for cardiopulmonary bypass",
abstract = "Aim. This prospective, randomized and controlled trial compares the use of human albumin (HA) and hydroxyethyl starch (HES) 130/0.4 in the priming solution for a non-biocompatible cardiopulmonary bypass (CPB) circuit. The effects of each substance on coagulation, postoperative blood loss and pro-inflammatory activities were examined. Methods. Thirty-six adult patients undergoing mitral valvular heart surgery were randomly assigned to either the HA or HES group; 500 mL of 5{\%} HA or 6{\%} HES 130/0.4 were added to the priming solution of the CPB circuit for each group, respectively. Coagulation variables were measured perioperatively; these variables included thromboelastographic (TEG) parameters and pro-inflammatory markers such as interleukin (IL)-6, IL-8 and tumor necrotic factor (TNF)-α. Postoperative blood loss and transfusion requirements were also assessed. Results. There were no significant intergroup differences in the coagulation variables (including TEG parameters), serum concentrations of IL-6, IL-8 and TNF-α, and blood loss or transfusion requirements. TEG parameters, which indicate the speed of solid clot formation and the strength of the fibrin clot, decreased up to 4 hours after CPB in both groups. Serum concentrations of IL-6, IL-8 and TNF-α were higher up to 12 hours after surgery compared to baseline values in both groups. Hemoglobin levels and platelet counts were lower up to 12 hours after surgery compared to baseline values in both groups. Conclusion. HES 130/0.4 was comparable to albumin as a component of the priming solution for a non-biocompatible CPB circuit. The two substances showed similar effects on coagulation variables, blood loss and pro-inflammatory activities in adult patients undergoing mitral valvular heart surgery.",
author = "Choi, {Y. S.} and Shim, {J. K.} and Hong, {S. W.} and Kim, {J. C.} and Kwak, {Y. L.}",
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Comparing the effects of 5% albumin and 6% hydroxyethyl starch 130/0.4 on coagulation and inflammatory response when used as priming solutions for cardiopulmonary bypass. / Choi, Y. S.; Shim, J. K.; Hong, S. W.; Kim, J. C.; Kwak, Y. L.

In: Minerva anestesiologica, Vol. 76, No. 8, 01.08.2010, p. 584-591.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparing the effects of 5% albumin and 6% hydroxyethyl starch 130/0.4 on coagulation and inflammatory response when used as priming solutions for cardiopulmonary bypass

AU - Choi, Y. S.

AU - Shim, J. K.

AU - Hong, S. W.

AU - Kim, J. C.

AU - Kwak, Y. L.

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Aim. This prospective, randomized and controlled trial compares the use of human albumin (HA) and hydroxyethyl starch (HES) 130/0.4 in the priming solution for a non-biocompatible cardiopulmonary bypass (CPB) circuit. The effects of each substance on coagulation, postoperative blood loss and pro-inflammatory activities were examined. Methods. Thirty-six adult patients undergoing mitral valvular heart surgery were randomly assigned to either the HA or HES group; 500 mL of 5% HA or 6% HES 130/0.4 were added to the priming solution of the CPB circuit for each group, respectively. Coagulation variables were measured perioperatively; these variables included thromboelastographic (TEG) parameters and pro-inflammatory markers such as interleukin (IL)-6, IL-8 and tumor necrotic factor (TNF)-α. Postoperative blood loss and transfusion requirements were also assessed. Results. There were no significant intergroup differences in the coagulation variables (including TEG parameters), serum concentrations of IL-6, IL-8 and TNF-α, and blood loss or transfusion requirements. TEG parameters, which indicate the speed of solid clot formation and the strength of the fibrin clot, decreased up to 4 hours after CPB in both groups. Serum concentrations of IL-6, IL-8 and TNF-α were higher up to 12 hours after surgery compared to baseline values in both groups. Hemoglobin levels and platelet counts were lower up to 12 hours after surgery compared to baseline values in both groups. Conclusion. HES 130/0.4 was comparable to albumin as a component of the priming solution for a non-biocompatible CPB circuit. The two substances showed similar effects on coagulation variables, blood loss and pro-inflammatory activities in adult patients undergoing mitral valvular heart surgery.

AB - Aim. This prospective, randomized and controlled trial compares the use of human albumin (HA) and hydroxyethyl starch (HES) 130/0.4 in the priming solution for a non-biocompatible cardiopulmonary bypass (CPB) circuit. The effects of each substance on coagulation, postoperative blood loss and pro-inflammatory activities were examined. Methods. Thirty-six adult patients undergoing mitral valvular heart surgery were randomly assigned to either the HA or HES group; 500 mL of 5% HA or 6% HES 130/0.4 were added to the priming solution of the CPB circuit for each group, respectively. Coagulation variables were measured perioperatively; these variables included thromboelastographic (TEG) parameters and pro-inflammatory markers such as interleukin (IL)-6, IL-8 and tumor necrotic factor (TNF)-α. Postoperative blood loss and transfusion requirements were also assessed. Results. There were no significant intergroup differences in the coagulation variables (including TEG parameters), serum concentrations of IL-6, IL-8 and TNF-α, and blood loss or transfusion requirements. TEG parameters, which indicate the speed of solid clot formation and the strength of the fibrin clot, decreased up to 4 hours after CPB in both groups. Serum concentrations of IL-6, IL-8 and TNF-α were higher up to 12 hours after surgery compared to baseline values in both groups. Hemoglobin levels and platelet counts were lower up to 12 hours after surgery compared to baseline values in both groups. Conclusion. HES 130/0.4 was comparable to albumin as a component of the priming solution for a non-biocompatible CPB circuit. The two substances showed similar effects on coagulation variables, blood loss and pro-inflammatory activities in adult patients undergoing mitral valvular heart surgery.

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