Comparing the Efficacy of 6% Hydroxyethyl Starch 130/0.4 and Human Albumin for Intravenous Fluid Replacement in Pediatric Open-Heart Surgery

Abstract

Background: Providing and maintaining normovolemic condition during major surgeries is a major<br />challenge, especially in children. In this respect, third-generation hydroxyethyl starches seem to<br />be more cost-effective than human albumin. However, the efficacy of 6% hydroxyethyl starch<br />(HES) 130/0.4 compared to other alternatives such as human albumin 5% remains uncertain in<br />children.<br />The present study aimed to assess the efficacy and safety of replacing human albumin 5% with<br />6% HES 130/0.4 for volume replacement therapy in children undergoing selective open cardiac<br />surgery.<br />Method: This randomized double-blinded clinical trial was performed on 59 children aged less than 2<br />years and ASA I-III who were candidated for selective open-heart surgery and referred to a<br />children medical center in 2014. The patients were randomly assigned via the block<br />randomization method to the case group (n = 30) receiving a solution of 6% HES 130/0.4 and<br />the control group (n = 29) receiving 5% human albumin.<br />There were no between-group differences in hemodynamic parameters—including pulse rate,<br />systolic and diastolic blood pressures, and mean blood pressure—at the time points of before<br />anesthesia induction, before and after pump insertion, and 24 hours after surgery.<br />Results: Comparisons of the laboratory indices indicated no differences between the 2 groups at the<br />different time points. The volume of packed cell and colloid fluids infused in the case and<br />control group was also similar.<br />Conclusions: Compared to human albumin 5%, 6% HES 130/0.4 is a safe alternative to fluid supply<br />during cardiac surgery among children.