Careaga RG, Carmona DVM, Medina CLE, Argüero SR

Language: Spanish
References: 10
Page: 83-87
PDF size: 116.81 Kb.

ABSTRACT

Objective: To assess alterations in coagulation, perioperative bleeding, and hemodynamic response with the use of a mid-molecular weight (130 kDa) pentastarch in the priming solution for the circuit of the extracorporeal circulation pump (ECP) in patients subjected to cardiac surgery with extracorporeal circulation. Setting: Cardiology Hospital, National Medical Center “Siglo XXI”.
Design: Randomized, blinded, controlled clinical assay, with two independent groups.
Statistical analysis: Descriptive statistics to characterize the groups and their comparison by means of Chi square and Mann-Whitney U-test.
Material and methods: Patients programmed for elective cardiac surgery with extracorporeal circulation. Group I constituted by patients in whom starch was used in the extracorporeal circulation machine for volume filling. Group II (control) with conventional solutions for the filling of the extracorporeal circulation machine. We analyzed: perioperative bleeding, coagulation times, platelets, fibrinogen, central venous pressure, left atrium pressure, mean arterial pressure, lactate.
Results: No differences existed between groups for the variables: age, gender, type of surgery, and hemodynamic parameters. Average time for the cardiopulmonary bypass was 96.6 ± 59 min and the average ischemia time was 60.3 ± 40.7 min. Statistically significant differences were observed during the postoperative period in regard to a larger need of hemoderivates (p = 0.005), a higher lactate level (p = 0.031), and more bleeding (p = 0.008) in the control group.
Conclusion: The use of hydroxyethyl-starch 130/0.4 as part of the solutions used to fill the circuit of the extracorporeal circulation device does not increase postoperative bleeding nor does it modify negatively the hemodynamic conditions of patients subjected to cardiac surgery with cardiopulmonary bypass.

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