Low molecular starch versus gelatin plasma expander during CPB: does it make a difference?

Perfusion
R H BoksA J Bogers

Abstract

Non-protein plasma expanders carry a risk of potentially severe allergic reactions. As prime for cardiopulmonary bypass, we routinely use a gelatin plasma expander. Plasma expanding during anesthesia is achieved with high molecular starch (200/0.5 kDalton) in combination with Ringer Lactate solution (RL) and in the Intensive Care Unit (ICU) with a low molecular starch (130/0.4 kDalton). We evaluated the feasibility of low molecular starch in combination with RL (group LMSRL) versus gelatin plasma expanding (group GPE) for priming CPB circuits in patients undergoing cardiac surgery in a randomized prospective trial. One hundred and eighty adults who underwent primary valve or coronary artery bypass graft (CABG) surgery were equally stratified into 3 series of 60 patients with the routinely used oxygenators; Capiox RX-25, CML Duo and Quadrox-D. Then they were randomised by drawing lots and allocated into the LMSRL or GPE groups. We compared hematocrit, hemoglobin, platelet count, activated clotting time (ACT), lactate and colloid osmotic pressure (COP), blood loss, transfusion need, urine production and ICU stay. In addition, we monitored the average trans-oxygenator fluid resistance (AFR) for each type of oxygenator. The COP is ...Continue Reading

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Citations

Mar 3, 2011·European Journal of Clinical Pharmacology·Xue-Yin ShiHu Liu
Sep 13, 2012·Annals of Surgery·Philippe J Van der Linden, Stefan G De Hert
Nov 3, 2015·The British Journal of Surgery·S H QureshiG J Murphy
Dec 6, 2014·Critical Care : the Official Journal of the Critical Care Forum·Matthias JacobAndrea Kurz
May 25, 2011·The Journal of Thoracic and Cardiovascular Surgery·Marco RanucciUNKNOWN European Association of Cardiothoracic Anaesthesiologists
Oct 16, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Marit HabicherMichael Sander
Jun 4, 2015·Critical Care : the Official Journal of the Critical Care Forum·Christian J Wiedermann
May 15, 2012·The Journal of Thoracic and Cardiovascular Surgery·Roberta J NavickisMahlon M Wilkes

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