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HES 130/0.4 (Voluven®) or human albumin in children younger than 2 yr undergoing non-cardiac surgery. A prospective, randomized, open label, multicentre trial

Published online by Cambridge University Press:  01 June 2008

T. Standl ,
H. Lochbuehler ,
C. Galli ,
A. Reich ,
G. Dietrich  and
H. Hagemann
T. Standl*
Affiliation:
Academic Hospital Solingen, Department of Anesthesia and Critical Care Medicine, Solingen, Hannover, Germany
H. Lochbuehler
Affiliation:
Childrens’ Hospital Dr. von Haunersches Kinderspital, Munich, Hannover, Germany
C. Galli
Affiliation:
University Clinics, Department of Anesthesiology, Freiburg, Hannover, Germany
A. Reich
Affiliation:
University Clinics, Department of Anesthesiology and Operative Intensive Medicine, Münster, Hannover, Germany
G. Dietrich
Affiliation:
University of Giessen, Department of Anesthesiology and Operative Intensive Medicine, Giessen, Hannover, Germany
H. Hagemann
Affiliation:
University Clinics, Department of Anesthesiology, Hannover, Germany
*
Department of Anesthesia and Critical Care Medicine, Academic Hospital Solingen, Gotenstrasse 1, 42653 Solingen, Germany. E-mail: standl@klinikumsolingen.de; Tel: +49 212 547 2600; Fax: +49 212 547 2234
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Summary

Background and objective

For perioperative volume therapy in infants and young children, human albumin has frequently been the colloid of choice. Recently, HES 130/0.4 (6% hydroxyethyl starch, Voluven®; Fresenius Kabi, Bad Homburg, Germany) was developed, which demonstrated improved pharmacokinetics and a favourable safety profile in adults compared with hydroxyethyl starch products with a less rapid metabolization.

Methods

Our prospective, controlled, randomized, open, multicentre pilot study was designed to obtain data on the effects of HES 130/0.4 compared with human albumin 5% with regard to haemodynamics in children <2 yr scheduled for elective non-cardiac surgery.

Results

A total of 81 patients were treated. Comparable amounts of both study solutions (16.0 mL kg−1 hydroxyethyl starch 130/0.4 vs. 16.9 mL kg−1 human albumin 5%) as well as add-on crystalloids were used until 4–6 h postoperatively. No differences were detected between the two treatment groups regarding perioperative stabilization of haemodynamics, coagulation parameters, blood gas analyses or other laboratory values. Blood loss was 96 ± 143 mL for hydroxyethyl starch and 145 ± 290 mL for human albumin (P > 0.05). There were no relevant differences in the amount of red blood cells, fresh frozen plasma or platelet concentrates in both treatment groups. Median length of ICU stay was 3.5 days (range 1–57 days, mean ± SD 7.6 ± 11.5 days) in the hydroxyethyl starch group and 6.0 days (range 1–71 days; mean ± SD 9.1 ± 14.2 days) in the human albumin group. There was no difference for hospital stay (median: 12 days for both groups).

Conclusions

Both HES 130/0.4 and human albumin 5% were effective for haemodynamic stabilization in non-cardiac surgery of young infants with no adverse impact on coagulation or other safety parameters in our study population.

Keywords

NEWBORNINFANTSURGERYCOLLOIDHYDROXYETHYL STARCHHUMAN ALBUMIN
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 6 , June 2008 , pp. 437 - 445
Copyright
Copyright © European Society of Anaesthesiology 2008

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