| Effect of Preoperative Volume Loading with New Hydroxyethyl Starch (6% HES 130/0.4) in Patients undergoing Off-Pump Coronary Artery Bypass Graft Surgery. |
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Sungwon Na, Sang Beom Nam, Dae Hee Kim, Jae Kwang Shim, Hye Gun Yang, Young Lan Kwak |
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ylkwak@yumc.yonsei.ac.kr
2Department of Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
3Department of Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
It is important to maintain adequate intravascular volume during off-pump coronary artery bypass surgery (OPCAB) to prevent hypotension. The aim of this study was to assess the effect of acute volume loading with new colloid solution, 6% hydroxyethyl starch (HES) 130/0.4 on hemodynamics and coagulation in patients undergoing OPCAB.
METHODS
With the IRB approval, forty patients undergoing OPCAB were allocated to two groups receiving 10 ml/kg of Plasma solution A (Control group, n = 21) or HES 130/0.4 (HES group, n = 19) for 30 min before pericardiotomy. We measured hemodynamic variables and coagulation parameters at 10 min after anesthesia induction (T1), 10 min after fluid loading (T2), 10 min after Y-graft formation (T3), and after sternum closure. Amount of infused fluid, blood loss, tranfusion and urine output were recorded intraoperatively and for 16 hr after surgery. Thromboelastography and electrolytes were also measured.
RESULTS
Both groups were similar in demographic data and fluid/blood volume during and after surgery. Cardiac index and right ventricular ejection fraction were maintained throughout the surgery in HES group but were decreased in Control group. The ratio of arterial oxygen partial pressure to inhaled oxygen fraction was increased in HES group after surgery. Thromboelastography and other parameters didn't demonstrate significant differences between the groups.
CONCLUSIONS
Acute HES loading before pericardiotomy could prevent the decrease of cardiac index and right ventricular ejection fraction in OPCAB patients. Additionally, it showed desirable effects on oxygenation without adverse effects on coagulation. |
| Key Words:
hemodynamic; hemostasis; hydroxyethyl starch |
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