Comparing the Effects of Hydroxy Ethyl Starch 6% and Gelatin as Replacement for Prime during Coronary Artery Bypass Graft Surgery

Abstract

Background: Several fluids have been used in priming the cardiopulmonary pump in coronary artery bypass graft surgery (CABG). Hydroxy-ethyl starch 6% (HES 6%) is a new colloid fluid which is widely used as a substitute for intraoperative fluid. Gelatin is also a commonly used colloid fluid for priming. However, it has some adverse effects, especially on the coagulation system. Methods: In this clinical trial, patients were randomized into two groups of HES 6% and gelatin. Prothrombin time (PT), partial thromboplastin time (PTT), and international normalized ratio (INR) were measured before surgery and immediately and 24 hours after the operation. Chest drainage (CD) was measured 24 hours after the operation. Urine output (UO) was measured during the first 24 postoperative hours. Blood urea nitrogen (BUN) and creatinine were measured before and 24 hours after surgery. Data was analyzed with SPSS. Findings: CD, INR, PT, and UO were not significantly different between HES 6% and gelatin groups. PTT was significantly higher in gelatin group only at the end of the surgery (56 ± 35 vs. 44 ± 27). BUN was only significantly higher in HES group 24 hours after surgery (19.9 ± 9.8 vs. 16.4 ± 7.6). Creatinine, sodium, and potassium concentrations did not differ at any time. Conclusion: HES and gelatin are both options for prime in cardiopulmonary pump. They have adverse effects on renal function and coagulation. More studies with larger sample size are recommended to clarify their advantages.

Keywords

• Hydroxy-ethyl starch
• Gelatin
• Coronary artery bypass graft