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Volume replacement with hydroxyethyl starch solution in children

J Boldt1, C Knothe, E Schindler

  • 1Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.

British Journal of Anaesthesia
|June 1, 1993
PubMed
Summary
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Low molecular weight hydroxyethyl starch solution (LMW-HES) is a safe and effective fluid for volume replacement in pediatric cardiac surgery. This study found LMW-HES comparable to albumin in hemodynamic stability and patient outcomes.

Area of Science:

  • Anesthesiology
  • Pediatric Cardiac Surgery
  • Critical Care Medicine

Background:

  • Fluid resuscitation is crucial in pediatric cardiac surgery.
  • Choosing the optimal fluid for pre-bypass volume replacement is important for patient outcomes.
  • Both hydroxyethyl starch solutions and albumin are used for volume replacement.

Purpose of the Study:

  • To compare the efficacy and safety of low molecular weight hydroxyethyl starch solution (LMW-HES) versus 20% albumin (HA) for fluid replacement in children undergoing cardiac surgery.
  • To evaluate hemodynamic parameters, laboratory variables, and postoperative outcomes in both groups.

Main Methods:

  • A randomized controlled trial involving 30 children undergoing cardiac surgery.
  • Group 1 (n=15) received LMW-HES (6%), and Group 2 (n=15) received 20% albumin for volume replacement before cardiopulmonary bypass (CPB).

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  • Hemodynamic data, coagulation profiles, blood loss, urine output, and creatinine levels were monitored pre- and post-CPB.

    • Main Results:

    • No significant differences were observed in hemodynamic data, coagulation variables, or postoperative blood loss between the LMW-HES and HA groups.
    • Albumin concentrations were higher in the HA group post-infusion, but colloid osmotic pressure remained similar between groups.
    • Post-bypass urine output and creatinine levels did not differ, and no anaphylactic reactions occurred.

    Conclusions:

    • LMW-HES is an effective and safe alternative to albumin for pre-bypass fluid management in pediatric cardiac surgery.
    • Both fluids demonstrate comparable safety profiles and do not significantly impact key perioperative outcomes.
    • Further research may explore long-term outcomes with LMW-HES in this population.