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The Annals of Thoracic Surgery, Vol 37, 40-46, Copyright © 1984 by The Society of Thoracic Surgeons
JK Kirklin, WA Lell and NT Kouchoukos
Hydroxyethyl starch or hetastarch (HES), a synthetic colloid for
intravascular volume expansion, was compared with albumin after coronary
artery operations in 30 patients (15 in each study group). Cardiac index,
atrial pressures, heart rate, and systolic blood pressure were similar in
both groups. There were no differences in cumulative urine output at 24
hours or in weight change during the first 7 postoperative days. Values for
colloid osmotic pressure, as well as for this variable minus left atrial
pressure, were lowest soon after bypass but returned to baseline within 4
hours, with no difference between groups in the first 24 hours or 7 days
after operation. Coagulation variables were similar, but prothrombin and
partial thromboplastin times were higher 12 hours postoperatively and
fibrinogen level was lower 7 days postoperatively in the patients receiving
HES. There was no clinical evidence of excessive bleeding, although
cumulative chest drainage at 12 and 24 hours was slightly higher in the HES
group (p = 0.09 and 0.08, respectively). We conclude that hetastarch is a
safe and effective colloid to use following coronary operations.
ARTICLES
Hydroxyethyl starch versus albumin for colloid infusion following cardiopulmonary bypass in patients undergoing myocardial revascularization
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