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Comparing the Effects of 5% Albumin and 6% Hydroxyethyl Starch 130/0.4 (Voluven) on Renal Function as Priming Solutions for Cardiopulmonary Bypass: A Randomized Double Blind Clinical Trial.

Hosseinzadeh Maleki M, Derakhshan P, Rahmanian Sharifabad A, Amouzeshi A - Anesth Pain Med (2016)

Bottom Line: GFR differences were statistically lower in Albumin group in comparison with Group B at 24, 48 and 72 hours postoperation.Platelet count difference and postoperative bleeding were significantly lower in Albumin group.Administration of Albumin compared to HES in patients with a normal renal function results in a lower drop of GFR and platelet count, less bleeding and lower rise of serum creatinine.

View Article: PubMed Central - PubMed

Affiliation: Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran.

ABSTRACT

Background: The ideal strategy to prime the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery is still a matter of debate.

Objectives: In this retrospective study, we examined Albumin solution and hydroxyethyl starch (HES) for priming the CPB circuit and evaluated the differences in kidney function and bleeding and coagulation status in the two groups of patients.

Patients and methods: Sixty consecutive patients undergoing elective coronary artery bypass grafting were studied. Patients were excluded due to emergency surgery, history of cardiac surgery, history of receiving medication with antiplatelet agents except ASA 80 (mg/day) within the previous five days, preoperative coagulation disorder, left ventricular ejection fraction less than 50%, preoperative renal dysfunction (serum creatinine > 1.4 mg/dL), preoperative hepatic dysfunction (serum aspartate/alanine amino transferase > 60 U/l), preoperative electrolyte imbalance, known hypersensitivity to HES and chronic diuretic therapy. The patients were divided randomly into two groups of HES (n = 30) and Albumin (n = 30). Hemodynamic parameters, serum creatinine concentrations and glomerular filtration rate, PT, PTT and INR were measured. Early bleeding was measured according to the first 24-hour drainage from the tube. Hemodynamics and all laboratory measurements were performed after induction of anesthesia and at the morning of the first, second and third postoperative days in the ICU.

Results: GFR differences were statistically lower in Albumin group in comparison with Group B at 24, 48 and 72 hours postoperation. Platelet count difference and postoperative bleeding were significantly lower in Albumin group.

Conclusions: Administration of Albumin compared to HES in patients with a normal renal function results in a lower drop of GFR and platelet count, less bleeding and lower rise of serum creatinine.

No MeSH data available.


Related in: MedlinePlus

Changes of Postoperative Glumerolar Filteration Rate (GFR) in the Two Study Groups
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fig25672: Changes of Postoperative Glumerolar Filteration Rate (GFR) in the Two Study Groups

Mentions: GFR in the Albumin group was higher at 24, 48 and 72 hours postoperatively, but it was not statistically significant (Table 2). GFR differences were statistically lower in Albumin group compared to HES (Voluven) group at 24 hours (-4.82 ± 8.04 vs. -12.14 ± 6.06, P < 0.0001), 48 hours (-12.69 ± 8.01 vs. -20.20 ± 9.47, p=0.002) and 72 hours (-16.39 ± 10.12 vs. -24.71 ± 12.44, P = 0.007) postoperatively (Table 3 and Figure 2). Figure 3 shows changes in creatinine levels of the two groups during postoperative period.


Comparing the Effects of 5% Albumin and 6% Hydroxyethyl Starch 130/0.4 (Voluven) on Renal Function as Priming Solutions for Cardiopulmonary Bypass: A Randomized Double Blind Clinical Trial.

Hosseinzadeh Maleki M, Derakhshan P, Rahmanian Sharifabad A, Amouzeshi A - Anesth Pain Med (2016)

Changes of Postoperative Glumerolar Filteration Rate (GFR) in the Two Study Groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834664&req=5

fig25672: Changes of Postoperative Glumerolar Filteration Rate (GFR) in the Two Study Groups
Mentions: GFR in the Albumin group was higher at 24, 48 and 72 hours postoperatively, but it was not statistically significant (Table 2). GFR differences were statistically lower in Albumin group compared to HES (Voluven) group at 24 hours (-4.82 ± 8.04 vs. -12.14 ± 6.06, P < 0.0001), 48 hours (-12.69 ± 8.01 vs. -20.20 ± 9.47, p=0.002) and 72 hours (-16.39 ± 10.12 vs. -24.71 ± 12.44, P = 0.007) postoperatively (Table 3 and Figure 2). Figure 3 shows changes in creatinine levels of the two groups during postoperative period.

Bottom Line: GFR differences were statistically lower in Albumin group in comparison with Group B at 24, 48 and 72 hours postoperation.Platelet count difference and postoperative bleeding were significantly lower in Albumin group.Administration of Albumin compared to HES in patients with a normal renal function results in a lower drop of GFR and platelet count, less bleeding and lower rise of serum creatinine.

View Article: PubMed Central - PubMed

Affiliation: Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran.

ABSTRACT

Background: The ideal strategy to prime the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery is still a matter of debate.

Objectives: In this retrospective study, we examined Albumin solution and hydroxyethyl starch (HES) for priming the CPB circuit and evaluated the differences in kidney function and bleeding and coagulation status in the two groups of patients.

Patients and methods: Sixty consecutive patients undergoing elective coronary artery bypass grafting were studied. Patients were excluded due to emergency surgery, history of cardiac surgery, history of receiving medication with antiplatelet agents except ASA 80 (mg/day) within the previous five days, preoperative coagulation disorder, left ventricular ejection fraction less than 50%, preoperative renal dysfunction (serum creatinine > 1.4 mg/dL), preoperative hepatic dysfunction (serum aspartate/alanine amino transferase > 60 U/l), preoperative electrolyte imbalance, known hypersensitivity to HES and chronic diuretic therapy. The patients were divided randomly into two groups of HES (n = 30) and Albumin (n = 30). Hemodynamic parameters, serum creatinine concentrations and glomerular filtration rate, PT, PTT and INR were measured. Early bleeding was measured according to the first 24-hour drainage from the tube. Hemodynamics and all laboratory measurements were performed after induction of anesthesia and at the morning of the first, second and third postoperative days in the ICU.

Results: GFR differences were statistically lower in Albumin group in comparison with Group B at 24, 48 and 72 hours postoperation. Platelet count difference and postoperative bleeding were significantly lower in Albumin group.

Conclusions: Administration of Albumin compared to HES in patients with a normal renal function results in a lower drop of GFR and platelet count, less bleeding and lower rise of serum creatinine.

No MeSH data available.


Related in: MedlinePlus