title: Effect of Hydroxyethyl Starch on Outcomes in High-Risk Vascular Surgery Patients: A Retrospective Analysis.
abstract: OBJECTIVE
  To assess the effect of using hydroxyethyl starch (HES) for intraoperative fluid therapy on outcomes in high-risk vascular surgery patients.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Single-center academic hospital.
  
  
  METHODS
  The study included 1,395 adult vascular surgery patients with peripheral vascular disease.
  
  
  METHODS
  Retrospective review of hospital databases.
  
  
  RESULTS
  Outcomes were compared between patients who were intraoperatively administered HES (Voluven [Fresenius Kabi, Bad Homburg, Germany] or Pentaspan [Bristol-Myers Squibb Canada, Montreal, Quebec, Canada]) versus patients who received only crystalloids during their procedure. Logistic regression was used to assess for association between these groups and mortality (in-hospital, 30-day), intensive care unit admission, hemodialysis requirement, vasopressor requirement, and ventilator requirement. Overall, 796 patients had complete fluid records and were included in the analysis. After adjustment for potential confounders, receiving an HES solution was associated with increased likelihood of 30-day mortality (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.05-3.80), postoperative requirement for hemodialysis (OR 6.17, 95% CI 1.09-35.10), intensive care unit admission (OR 3.52, 95% CI 2.15-5.74), and mechanical ventilation (OR 3.16, 95% CI 1.84-5.41).
  
  
  CONCLUSIONS
  Intraoperative administration of HES was associated with an increased likelihood of adverse outcomes compared with use of crystalloids alone.
authors.affiliation: Departments of Critical Care, Dalhousie University, Halifax, Nova Scotia, Canada; Trauma Nova Scotia, Halifax, Nova Scotia, Canada. Electronic address: greenrs@dal.ca.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Green
authors.affiliation: Critical Care, Department of Mathematics and Statistics, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Butler
authors.affiliation: Anaesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Hicks
authors.affiliation: Trauma Nova Scotia, Halifax, Nova Scotia, Canada.
authors.forename: Mete
authors.initials: M
authors.lastname: Erdogan
mesh_terms: D000368:Aged; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D010952:Plasma Substitutes / Q000494:pharmacology*; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
chemical_list: C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes
keywords: colloid; hydroxyethyl starch (HES); outcomes; surgery; vascular