Effect of 6% Hydroxyethyl Starch 130/0.4 on Inflammatory Response and Pulmonary Function in Patients Having Cardiac Surgery

To the Editor We have read the article written by Lee et al1 with great interest. It is a welcome investigation that compared the effect of administration of 6% HES 130/0.4 and 5% human albumin on inflammatory response and pulmonary function in patients having cardiac surgery. We agree with their conclusion that the administration of 6% hydroxyethyl starch (HES) 130/0.4 versus 5% human albumin for intravascular volume replacement during cardiac surgery did not affect the perioperative inflammatory response or postoperative pulmonary function. However, there are several aspects of this study that need to be clarified and discussed. In the Intraoperative Fluid Management section of this article, the authors described 6 situations to administer HES 130/0.4 or 5% human albumin. However, priming solution that contains HES or human albumin also plays an important role during cardiopulmonary bypass and may even influence patients’ outcome.2–4 Therefore, we suggest that the volume of investigation solution should include the priming solution. Moreover, in the study, the authors compared the duration of aortic cross clamp but not the duration of cardiopulmonary bypass. However, there is a positive correlation between the magnitude of the interleukin-6 response to cardiopulmonary bypass and the duration of cardiopulmonary bypass but not the duration of aortic cross clamp.5 We believe that this article would be much stronger and useful to readers by addressing the above issues. Tingju Hu, MSDepartment of AnesthesiologyThe Affiliated Hospital of Guizhou Medical UniversityGuiyang, China Rui Duan, BSDepartment of Pain TreatmentThe Second People’s Hospital of GuiyangGuiyang, China Xiaohua Zou, MDJunqing Li, MSJing Shi, MDDepartment of AnesthesiologyThe Affiliated Hospital of Guizhou Medical UniversityGuiyang, China[email protected]