Effect of hydroxyethyl starch on bleeding after cardiopulmonary bypass: a meta-analysis of randomized trials

The Journal of Thoracic and Cardiovascular Surgery
R J NavickisM M Wilkes

Abstract

The effects of hydroxyethyl starch on bleeding after cardiopulmonary bypass were determined. A meta-analysis was performed of postoperative blood loss in randomized clinical trials of hydroxyethyl starch versus albumin for fluid management in adult cardiopulmonary bypass surgery. Impacts of hydroxyethyl starch molecular weight and molar substitution were assessed. Randomized trials directly comparing different hydroxyethyl starch solutions were also included. Eighteen trials with 970 total patients were included. Compared with albumin, hydroxyethyl starch increased postoperative blood loss by 33.3% of a pooled SD (95% confidence interval, 18.2%-48.3%; P < .001). Risk of reoperation for bleeding was more than doubled by hydroxyethyl starch (relative risk, 2.24; 95% confidence interval, 1.14-4.40; P = .020). Hydroxyethyl starch increased transfusion of red blood cells by 28.4% of a pooled SD (95% confidence interval, 12.2%-44.6%; P < .001), of fresh-frozen plasma by 30.6% (95% confidence interval, 8.0%-53.1%; P = .008), and of platelets by 29.8% (95% confidence interval, 3.4%-56.2%; P = .027). None of these effects differed significantly between hydroxyethyl starch 450/0.7 and 200/0.5. Insufficient data were available for hydroxy...Continue Reading

References

May 1, 1992·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·M E VillarinoW R Jarvis
Feb 1, 1991·Journal of Cardiothoracic and Vascular Anesthesia·J BoldtG Hempelmann
Oct 1, 1990·Journal of Cardiothoracic Anesthesia·J BoldtG Hempelmann
Nov 1, 1991·British Journal of Anaesthesia·J BoldtG Hempelmann
Oct 1, 1985·The Annals of Thoracic Surgery·P Belcher
May 1, 1988·Journal of Clinical Pharmacology·J L FalkM H Weil
Dec 1, 1982·The Annals of Thoracic Surgery·J T DiehlD M Cosgrove
Dec 1, 1982·The Annals of Thoracic Surgery·D A PalanzoJ A Waldhausen
Nov 1, 1983·The Annals of Thoracic Surgery·C R SaundersR L Bick
May 1, 1984·The Annals of Thoracic Surgery·P Belcher, S C Lennox
Mar 1, 1980·Canadian Anaesthetists' Society Journal·K BalasaraswathiC Azad
Jan 1, 1995·Artificial Cells, Blood Substitutes, and Immobilization Biotechnology·A UsubaT Kamitani
Jan 1, 1994·Journal of Clinical Pharmacology·L MastroianniM S Chow
Jun 1, 1994·Journal of Cardiothoracic and Vascular Anesthesia·J BoldtG Hempelmann
Jul 1, 1995·Der Anaesthesist·H BrockH Bergmann
Jun 1, 1993·British Journal of Anaesthesia·J BoldtG Hempelmann
Apr 1, 1996·Journal of Cardiothoracic and Vascular Anesthesia·D BrutocaoA M Lynn
Aug 1, 1996·The Thoracic and Cardiovascular Surgeon·A WahbaD E Birnbaum
Apr 1, 1997·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·I TigchelaarW van Oeveren
Feb 10, 1998·The Annals of Thoracic Surgery·T Shin'okaR A Jonas
Feb 25, 1998·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·L A HerwaldtT M Perl
Aug 26, 1998·Journal of Cardiothoracic and Vascular Anesthesia·J AukermanR Mosca
Jul 20, 1999·Perfusion·D A PalanzoN J Manley
Apr 6, 2000·Journal of Applied Physiology·C S CoxS J Allen

❮ Previous
Next ❯

Citations

Nov 29, 2012·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·John M Murkin
Mar 21, 2013·Critical Care : the Official Journal of the Critical Care Forum·Carlos A Estrada, Raghavan Murugan
Jul 25, 2013·American Journal of Veterinary Research·Duana McBrideLisa Smart
Dec 19, 2014·Journal of Intensive Care·Daisuke ToyodaYoshifumi Kotake
Dec 20, 2013·Intensive Care Medicine·Julian BionSimon Finfer
Oct 19, 2014·British Journal of Anaesthesia·K RaghunathanUNKNOWN ADQI XII Investigators Group
Dec 6, 2014·Critical Care : the Official Journal of the Critical Care Forum·Matthias JacobAndrea Kurz
Mar 6, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Alessandra RizzaZaccaria Ricci
Mar 24, 2016·Intensive Care Medicine·Christian J WiedermannAnders Perner
Feb 7, 2015·Journal of Veterinary Emergency and Critical Care·Katja N AdamikNadine Regenscheit
Apr 27, 2013·Carbohydrate Polymers·Stefan HoffmannKarsten Mäder
Mar 14, 2014·Scandinavian Journal of Clinical and Laboratory Investigation·Nahreen TynngårdSören Berg
Feb 2, 2013·Scandinavian Journal of Clinical and Laboratory Investigation·Dag WinstedtUlf Schött
Dec 3, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Gregory A HansMarc Senard
Apr 23, 2015·Critical Care : the Official Journal of the Critical Care Forum·Roberta J NavickisMahlon M Wilkes
Dec 19, 2012·The Journal of Thoracic and Cardiovascular Surgery·Roberta J NavickisMahlon M Wilkes
Dec 19, 2012·The Journal of Thoracic and Cardiovascular Surgery·Ahmet Baris DurukanHasan Alper Gurbuz
Oct 4, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Fabrizzio Sacchet-CardozoMichael Essandoh
Aug 20, 2014·Anesthesia and Analgesia·Karthik RaghunathanAndrew D Shaw
May 28, 2014·Seminars in Cardiothoracic and Vascular Anesthesia·Enrique MoretAlexey A Schramko
Jan 18, 2014·Journal of Pharmacy Practice·Gary R Haynes
Nov 17, 2016·Current Medical Research and Opinion·N El GkotmiM S Elisaf
Apr 17, 2018·Acta Anaesthesiologica Scandinavica·J H LaakeUNKNOWN Board of the Scandinavian Society of Anaesthesiology Intensive Care Medicine (SSAI)
Mar 19, 2019·Acta Anaesthesiologica Scandinavica·Jes R JohansenMorten H Møller
Jun 23, 2019·Journal of Veterinary Emergency and Critical Care·Gaby van Galen, Gayle Hallowell
Aug 28, 2014·Journal of Veterinary Emergency and Critical Care·Polly A GloverRebecca Kirby
Jan 7, 2020·The British Journal of Surgery·N HemingD Annane
Feb 29, 2020·Journal of Veterinary Emergency and Critical Care·Thomas H EdwardsJames L Edwards
Aug 22, 2013·Anesthesiology·A B Johan GroeneveldMahlon M Wilkes
Apr 5, 2016·European Journal of Anaesthesiology·Gernot MarxMichaela Eikermann
Jun 8, 2013·Current Opinion in Critical Care·Nicolai Haase, Anders Perner

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