Document Detail


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.
MedLine Citation:
PMID:  20661198     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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)-a. 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-a, 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-a 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.
Authors:
Y S Choi; J K Shim; S W Hong; J C Kim; Y L Kwak
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-05-27
Journal Detail:
Title:  Minerva anestesiologica     Volume:  76     ISSN:  1827-1596     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  584-91     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation / drug effects*
Cardiopulmonary Bypass*
Female
Glycoproteins / administration & dosage*
Heart Valve Diseases / surgery
Hetastarch / administration & dosage*
Humans
Inflammation / immunology
Male
Middle Aged
Mitral Valve
Plasma Substitutes / administration & dosage*
Postoperative Hemorrhage / epidemiology*
Prospective Studies
Serum Albumin / administration & dosage*
Chemical
Reg. No./Substance:
0/ALB protein, human; 0/Glycoproteins; 0/Plasma Substitutes; 0/Serum Albumin; 9005-27-0/Hetastarch

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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