Nagaya Kei, Yoshida Akiko, Ito Yosuke, Watanabe Suguru, Minagawa Tadanori, Saijo Yoshifumi
Department of Anesthesia, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
Department of Cardiovascular Surgery, Sendai Medical Center, Sendai, Japan.
Ann Med Surg (Lond). 2022 Aug 24;81:104475. doi: 10.1016/j.amsu.2022.104475. eCollection 2022 Sep.
Acute kidney injury (AKI) after cardiac surgery increases the risk of morbidity and mortality. Hydroxyethyl starch (HES) is often used during surgery due to its plasma-volume expanding effect, but the impact of HES 130/0.4 on renal function in patients undergoing cardiac surgery remains unclear. The aim of our study is to investigate the impact of HES 130/0.4 on postoperative renal function in patients undergoing cardiac surgery using cardiopulmonary bypass.
Our study was a randomised, single-center, single-blind study conducted on 60 adult patients who underwent cardiac surgery using cardiopulmonary bypass: 30 patients were intraoperatively administered with HES 130/0.4; the other 30 with Ringer's bicarbonate. The primary endpoints were occurrence of AKI within 30 days of surgery and the disease stages.
The mean dose of 6% HES 130/0.4 was 28 ml/kg. AKI occurred within 30 days of the operation in 8 cases (28.6%) in the HES group and 6 cases (21.4%) in the crystalloid group (no significance: = 0.5371). Disease stages were as follows: "no AKI", "stage 1", "stage 2″ and "stage 3″, accounting for 20 cases (71.5%), 6 cases (21,4%), 2 cases (7.1%), and 0 cases, respectively, in the HES group, and 22 cases (78.6%), 6 cases (21.4%), 0 cases, and 0 cases, respectively, in the crystalloid group (no significance: = 0.3508).
There was no significant difference in the occurrences or stages of AKI during the 30 days following cardiac surgery with cardiopulmonary bypass between patients administered with HES 130/0.4 or Ringer's bicarbonate.
心脏手术后的急性肾损伤（AKI）会增加发病和死亡风险。羟乙基淀粉（HES）因其扩容作用常在手术中使用，但HES 130/0.4对心脏手术患者肾功能的影响仍不明确。本研究旨在探讨HES 130/0.4对接受体外循环心脏手术患者术后肾功能的影响。
本研究是一项随机、单中心、单盲研究，对60例接受体外循环心脏手术的成年患者进行：30例患者术中给予HES 130/0.4；另外30例给予碳酸氢钠林格液。主要终点为术后30天内AKI的发生情况及疾病分期。
6% HES 130/0.4的平均剂量为28 ml/kg。HES组8例（28.6%）患者在术后30天内发生AKI，晶体液组6例（21.4%）（无显著性差异：= 0.5371）。疾病分期如下：“无AKI”、“1期”、“2期”和“3期”，HES组分别占20例（71.5%）、6例（21.4%）、2例（7.1%）和0例，晶体液组分别占22例（78.6%）、6例（21.4%）、0例和0例（无显著性差异：= 0.3508）。
接受HES 130/0.4或碳酸氢钠林格液治疗的患者在体外循环心脏手术后30天内AKI的发生率和分期无显著差异。
