Intraoperative hydroxyethyl starch 70/0.5 administration may increase postoperative bleeding: a retrospective cohort study.
OBJECTIVE
Studies evaluating the safety of hydroxyethyl starch with a molecular weight of 70 kDa and a molar substitution ratio of 0.5 (HES 70/0.5) are scarce in the literature. In this study, we investigated the relationship between intraoperative HES 70/0.5 administration and postoperative bleeding.


METHODS
This is a single-center, retrospective cohort study. Subjects were postoperative adult patients who stayed in the intensive care unit (ICU) for more than 24 h during the period from January 1, 2010 to December 31, 2012. We compared postoperative adult patients with and without intraoperative HES 70/0.5 administration. The primary outcome was the drainage volume from surgical sites during the first 24 h after ICU admission. We conducted propensity score matching between the control group and the HES group.


RESULTS
We analyzed data for 769 patients who met our inclusion criteria. Using propensity score matching, we successfully created 119 matched pairs from the HES group and control group, with no significant differences in patient characteristics. The drainage volume during the first 24 h after ICU admission was greater in the HES group than in the control group (400 ± 479 vs. 260 ± 357 mL, p < 0.003).


CONCLUSIONS
Our retrospective cohort study suggests that intraoperative HES 70/0.5 administration is associated with increased postoperative bleeding.
Intensive Care Unit, Jikei University Hospital, Tokyo, Japan. j.toko.fukushima105@gmail.com.|Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan. j.toko.fukushima105@gmail.com.
Toko
T
Fukushima
Intensive Care Unit, Jikei University Hospital, Tokyo, Japan.|Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
Shigehiko
S
Uchino
Epidemiology and Preventive Service, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Tomoko
T
Fujii
Intensive Care Unit, Jikei University Hospital, Tokyo, Japan.|Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
Masanori
M
Takinami
Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
Shoichi
S
Uezono
D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects* / Q000627:therapeutic use; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D012189:Retrospective Studies
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes
Coagulopathy; Colloids; Fluid resuscitation; Hydroxyethyl starch; Postoperative complications