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The effect of HES (130/0.4) usage as the priming solution on renal function in children undergoing cardiac surgery

Fulya G Akkucuk1, Meral Kanbak, Banu Ayhan

  • 1Department of Anesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Renal Failure
|December 12, 2012
PubMed

Insights

Hydroxyethyl starch (HES) did not negatively impact renal function in pediatric cardiac surgery patients. This fluid can be safely used as a priming solution during cardiopulmonary bypass, showing no adverse effects on kidney function.

Area of Science:

  • Pediatric Cardiac Surgery
  • Nephrology
  • Anesthesiology

Background:

  • Limited data exists on hydroxyethyl starch (HES) use in pediatric patients.
  • Assessing renal function effects of HES versus Ringer's lactate (RL) as a priming solution in pediatric cardiac surgery is crucial.

Purpose of the Study:

  • To evaluate the safety and efficacy of hydroxyethyl starch (HES) (130/0.4) as a cardiopulmonary bypass (CPB) priming solution in pediatric patients.
  • To compare the effects of HES and Ringer's lactate (RL) on renal function markers in children undergoing cardiac surgery.

Main Methods:

  • A prospective, randomized study involving 24 pediatric patients undergoing cardiac surgery.
  • Patients received either RL (Group I) or HES (130/0.4) (Group II) as the CPB priming solution.
  • Renal function markers including serum creatinine, BUN, β2-microglobulin, cystatin C, and urinary albumin/creatinine ratio were monitored at multiple time points.

Main Results:

  • No significant differences were observed between HES and RL groups in cystatin C, β2-microglobulin, FENa, urine albumin/creatinine ratio, creatinine clearance, fluid balance, or urine output.
  • While creatinine clearance increased in the RL group, it remained stable in the HES group.
  • Urine albumin/creatinine ratio increased post-CPB in the HES group and during CPB in the RL group, with no overall group difference.

Conclusions:

  • Hydroxyethyl starch (HES) (130/0.4) can be safely administered as a priming solution in pediatric patients undergoing cardiac surgery.
  • HES did not demonstrate negative effects on renal function in this pediatric cohort.
  • The study supports the use of HES as an alternative priming solution in pediatric cardiac surgery.
Abstract

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