Intraoperative hydroxyethyl starch 70/0.5 administration may increase postoperative bleeding: a retrospective cohort...

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Pharmacology

Background:

• Hydroxyethyl starch (HES) solutions are widely used for fluid resuscitation.
• Limited data exists on the safety of specific HES formulations, such as HES 70/0.5.
• Postoperative bleeding is a significant concern in surgical patients.

Purpose of the Study:

• To investigate the association between intraoperative administration of hydroxyethyl starch 70 kDa/0.5 molar substitution (HES 70/0.5) and postoperative bleeding.
• To evaluate the safety profile of HES 70/0.5 in adult patients requiring intensive care unit (ICU) stay.

Main Methods:

• Retrospective cohort study involving adult postoperative patients admitted to the ICU.
• Comparison of patients who received intraoperative HES 70/0.5 versus those who did not.
• Propensity score matching was used to control for confounding variables.
• Primary outcome: 24-hour postoperative drainage volume after ICU admission.

Main Results:

• 119 matched pairs of patients were analyzed after propensity score matching.
• Patients who received intraoperative HES 70/0.5 exhibited significantly greater 24-hour postoperative drainage (400 ± 479 mL) compared to the control group (260 ± 357 mL).
• The difference in drainage volume was statistically significant (p < 0.003).

Conclusions:

• Intraoperative administration of HES 70/0.5 appears to be associated with an increased risk of postoperative bleeding.
• Findings suggest caution when using HES 70/0.5 in surgical patients due to potential hemostatic effects.
• Further prospective studies are warranted to confirm these findings and elucidate the underlying mechanisms.