Albumin utilization in cardiac surgery after transition to hydroxyethyl starch 130/0.4
| Autor: | Daniel L. Moellentin, Brandon E. Brodeur, David B. Romerill, Alexander Y. Toyoda |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Anemia Plasma Substitutes Renal function Hydroxyethyl starch Hydroxyethyl Starch Derivatives Postoperative Complications Albumins medicine Humans Pharmacology (medical) Cardiac Surgical Procedures Hetastarch Aged Retrospective Studies business.industry Albumin Odds ratio Middle Aged medicine.disease Cardiac surgery Treatment Outcome Anesthesia Female business medicine.drug |
| Zdroj: | Journal of pharmacy practice. 25(6) |
| ISSN: | 1531-1937 |
| Popis: | Objective: Evaluate the impact of replacing hydroxyethyl starch (HES) 670/0.75 with lower molecular weight HES 130/0.4 on albumin utilization in cardiac surgery, as well as any impact on renal function and bleeding. Design: A pre- and postimplementation, retrospective analysis. Setting: Community, not-for-profit, tertiary medical center. Participants: One hundred forty-six patients undergoing nonemergent cardiac bypass graft and cardiac valve surgeries after exclusion for documented anemia, malignancy, coagulation disorder, end-stage renal disease, or personal objection to receiving blood products. Intervention: HES 130/0.4 utilization instead of HES 670/0.75 for volume expansion. Measurements and Main Results: Patients were less likely to be administered albumin intraoperatively (odds ratio [OR] 0.16, confidence interval [CI] 0.08-0.35, P < .001). When albumin was utilized, intraoperative amounts were similar (mean ± standard deviation [SD]: 36.1 ± 17.1 g vs 43.8 ± 15.5 g, P = .16). Patients were more likely to receive an intraoperative HES product after the formulary change (OR 11.1, CI 4.4-27.6, P < .001) as well as larger volumes (mean ± SD: 743 ± 544 mL vs 500 ± 0 mL, P = .01). No differences were detected in mean baseline-to-discharge changes in serum creatinine or in postoperative urine output, nor were there differences in clinically significant bleeding. Conclusions: Change to a lower molecular weight HES decreased intraoperative albumin utilization and increased HES utilization with no detected difference in renal function or bleeding complications. |
| Databáze: | OpenAIRE |
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