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dc.contributor.authorVan der Linden, Philippeen_US
dc.contributor.authorDumoulin, Melanieen_US
dc.contributor.authorVan Lerberghe, Celineen_US
dc.contributor.authorTorres, Cristel Sanchezen_US
dc.contributor.authorWillems, Arianeen_US
dc.contributor.authorFaraoni, Daviden_US
dc.date.accessioned2015-04-01T15:30:55Z
dc.date.issued2015en_US
dc.identifier.citationVan der Linden, Philippe, Melanie Dumoulin, Celine Van Lerberghe, Cristel Sanchez Torres, Ariane Willems, and David Faraoni. 2015. “Efficacy and safety of 6% hydroxyethyl starch 130/0.4 (Voluven) for perioperative volume replacement in children undergoing cardiac surgery: a propensity-matched analysis.” Critical Care 19 (1): 87. doi:10.1186/s13054-015-0830-z. http://dx.doi.org/10.1186/s13054-015-0830-z.en
dc.identifier.issn1364-8535en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:14351377
dc.description.abstractIntroduction: Six percent hydroxyethyl starch (HES) 130/0.4 is considered an alternative to human albumin (HA) and crystalloids for volume replacement in children undergoing cardiac surgery. In this large propensity-matched analysis, we aimed to assess the efficacy and safety of replacing HA with HES for intraoperative volume therapy in children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: We retrospectively reviewed our database, including children who underwent cardiac surgery between January 2002 and December 2010. Four percent HA was used until 2005; it was replaced by HES thereafter. Demographic data, intra- and postoperative blood loss and blood component transfusions were recorded, together with the incidence of postoperative complications and mortality. We performed a propensity-matched analysis using 13 possible confounding factors to compare children who received either HES or HA intraoperatively. The primary objectives included the effects of both fluids on intraoperative fluid balance (difference between fluids in and fluids out (efficacy)) and blood loss and exposure to allogeneic blood products (safety). Secondary safety outcomes were mortality and the incidence of postoperative renal dysfunction. Results: Of 1,832 children reviewed, 1,495 were included in the analysis. Intraoperative use of HES was associated with a less positive fluid balance. Perioperative blood loss, volume of red blood cells and fresh frozen plasma administered, as well as the number of children who received transfusions, were also significantly lower in the HES group. No difference was observed regarding the incidence of postoperative renal failure requiring renal replacement therapy or of morbidity and mortality. Conclusions: These results confirm that the use of HES for volume replacement in children during cardiac surgery with CPB is as safe as HA. In addition, its use might be associated with less fluid accumulation. Further large studies are needed to assess whether the reduction in fluid accumulation could have a significant impact on postoperative morbidity and mortality.en
dc.language.isoen_USen
dc.publisherBioMed Centralen
dc.relation.isversionofdoi:10.1186/s13054-015-0830-zen
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376346/pdf/en
dash.licenseLAAen_US
dc.titleEfficacy and safety of 6% hydroxyethyl starch 130/0.4 (Voluven) for perioperative volume replacement in children undergoing cardiac surgery: a propensity-matched analysisen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalCritical Careen
dash.depositing.authorFaraoni, Daviden_US
dc.date.available2015-04-01T15:30:55Z
dc.identifier.doi10.1186/s13054-015-0830-z*
dash.contributor.affiliatedFaraoni, David


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