Key result
Intraoperative use of 6% hydroxyethyl starch (130/0.4) did not significantly increase the incidence of post-operative renal dysfunction compared to crystalloids alone in patients undergoing CABG (6.06% vs 1.52%, p=0.17).
Why the study?
The potential nephrotoxic effect of hydroxyethyl starch used as volume therapy in cardiac surgery is a major clinical concern.
Does intraoperative infusion of 6% hydroxyethyl starch (130/0.4) harm renal function in cardiac surgical patients undergoing CABG?
Cohort (n=132)
No
Does intraoperative infusion of 6% hydroxyethyl starch (130/0.4) harm renal function in cardiac surgical patients undergoing CABG?
Absolute Event Rate: 6.06% vs 1.52%
p-value: p=0.17
Intraoperative use of 6% hydroxyethyl starch (130/0.4) up to 500 mL does not significantly worsen renal function compared to crystalloids alone in patients undergoing elective CABG.
Supports limited HES use without clear renal harm in CABG; leaves open confirmation by randomized trials.
Background: The possibility of nephrotoxic effect caused by hydroxy ethyl starch (HES) used as volume therapy in this particular setting is of major clinical concern. We conducted this retrospective study to look for the possible nephrotoxic effects and other systemic adverse effects if any, of 6% HES 130 kD, 0.4 DS used as intraoperative volume expander in the cardiac surgery setting. Aims and Objectives: This study aims to determine whether the infusion of 6% hydroxyethyl starch (130/0.4) harms renal function in cardiac surgical patients. Materials and Methods: The present study was a retrospective study. Sixty-six patients who received crystalloids with hydroxyethyl starch and a matched control of 66 patients based on age and sex and other baseline parameters who received crystalloids only were part of the study. The data extracted from the electronic medical record include patient demographics, details for additive EURO score, and pre-operative data that include details of comorbid illnesses, namely, hypertension and diabetes, plasma hemoglobin, serum creatinine, and eGFR. Results: There is no statistically significant difference in serum creatinine and incidence of post-operative renal dysfunction between the study groups. There was a higher rate of re-exploration and duration of intensive care unit, and hospital stay. Conclusion: In our study, HES 130/0.4 in the dose used as a plasma expander did not adversely affect renal function in cardiac surgical patients undergoing CABG. The study recommends further detailed studies in this area involving multiple centers.
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Das et al. (2022) conducted a cohort in Cardiac surgical patients undergoing CABG (n=132). 6% Hydroxyethyl starch (130/0.4) vs. Crystalloids only was evaluated on Incidence of post-operative renal dysfunction (p=0.17). Intraoperative use of 6% hydroxyethyl starch (130/0.4) did not significantly increase the incidence of post-operative renal dysfunction compared to crystalloids alone in patients undergoing CABG (6.06% vs 1.52%, p=0.17).
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