title: The impact of 30 ml/kg hydroxyethyl starch 130/0.4 vs hydroxyethyl starch 130/0.42 on coagulation in patients undergoing abdominal surgery.
abstract: OBJECTIVE
  Hydroxyethyl starches (HES) 130/0.4 (Voluven;) and 130/0.42 (Venofundin;) impair coagulation less than older HES solutions with higher molecular weight and molar substitution. Thus, these may be used in high doses up to 50 ml/kg/day. The aim of this study was to investigate and compare the effects of HES 130/0.4 versus HES 130/0.42 on coagulation after the intraoperative infusion of 30 ml/kg in patients undergoing major abdominal surgery.
  
  
  METHODS
  Fifty two patients scheduled for elective major abdominal surgery were randomized to receive 30 ml/kg of HES 130/0.4 or HES 130/0.42 intraoperatively. Coagulation variables were assessed before and after infusion of the colloid solution using thrombelastography.
  
  
  RESULTS
  Data from 49 patients, 25 patients in the HES 130/0.4 and 24 in the HES 130/0.42 group, were analyzed. Measurements of reaction time, kinetic time, α-angle, maximum amplitude and coagulation index before and after colloid infusion did not differ between the groups. Within each group, after colloid infusion, reaction time did not change significantly, while α-angle, maximum amplitude and coagulation index values were significantly decreased (P <0.01, P<0.001 and P<0.001, respectively in HES 130/0.4 group and P<0.01, P<0.001 and P<0.01, respectively in HES 130/0.42 group). Kinetic time was significantly increased (P<0.001) in both the groups. In both groups, all thrombelastographic measurements after colloid infusion were found within normal limits.
  
  
  CONCLUSIONS
  HES 130/0.4 and HES 130/0.42 showed similar, not clinically significant effects on coagulation, as assessed by thrombelastography, when a dose of 30 ml/kg was administered in patients undergoing major abdominal surgery.
authors.affiliation: Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, 76 Vassilissis Sophias Ave., Athens, Greece. c_staikou@yahoo.gr
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Staikou
authors.forename: Anteia
authors.initials: A
authors.lastname: Paraskeva
authors.forename: Argyro
authors.initials: A
authors.lastname: Fassoulaki
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects*; D004311:Double-Blind Method; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D008875:Middle Aged; D010952:Plasma Substitutes / Q000494:pharmacology*; D013916:Thrombelastography
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes