Perioperative clinical and economic outcomes associated with replacing first-generation high molecular weight hydroxyethyl starch (Hextend®) with low molecular weight hydroxyethyl starch (Voluven®) at a large medical center

Perioperative Medicine
Raquel R BartzTong J Gan

Abstract

Several plasma volume expander alternatives exist to enhance intravascular volume status in patients undergoing surgery. The optimal intravascular volume expander in the perioperative setting is currently unknown. Low molecular weight hetastarch, Voluven® (130/0.4), may have a better safety profile than high molecular weight hetastarch, Hextend® (450/0.7). We examined the clinical and cost outcomes of converting from Hextend® to Voluven® in a large tertiary medical center. Using a large electronic database, we retrospectively compared two different time periods (2009 and 2010) where the availability of semisynthetic colloids changed. Perioperative and postoperative outcomes including the use of red blood cells (RBC), platelets and coagulation factors, length of stay in the postoperative acute care unit (PACU), intensive care unit and hospital, as well as 30-day and 1-year mortality were compared. In addition, direct acquisition costs of all intraoperative and PACU colloids and crystalloid use were determined. A total of 4,888 adult subjects were compared of which 1,878 received Hextend® (pre-conversion) and 2,759 received Voluven® (post-conversion) during two separate 7-month periods within 1 year apart, with the remainder rece...Continue Reading

References

May 28, 2004·The New England Journal of Medicine·Simon FinferUNKNOWN SAFE Study Investigators
Jan 11, 2008·The New England Journal of Medicine·Frank M BrunkhorstUNKNOWN German Competence Network Sepsis (SepNet)
Jun 11, 2009·Anesthesiology·Martin WestphalHugo Van Aken
Aug 12, 2010·Health Services Research·John D BirkmeyerJonathan S Skinner
Jan 11, 2011·Annals of Surgery·A B Johan GroeneveldMahlon M Wilkes
Apr 15, 2011·BMC Surgery·José M RamírezUNKNOWN Spanish working group on fast track surgery
Jun 29, 2012·The New England Journal of Medicine·Anders PernerUNKNOWN Scandinavian Critical Care Trials Group
Oct 19, 2012·The New England Journal of Medicine·John A MyburghUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
May 8, 2013·Clinical Orthopaedics and Related Research·Kevin J BozicMervyn Maze

❮ Previous
Next ❯

Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SAS

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.