Hydroxyethyl Starch 130/0.4 and the Risk of Acute Kidney Injury After Cardiopulmonary Bypass: A Single-Center Retrospective Study.

LAGNY, Marc-Gilbert; ROEDIGER, Laurence; KOCH, Jean-Noël; DUBOIS, Fanny; SENARD, Marc; Donneau, Anne-Françoise; HUBERT, Marie-Bernard; HANS, Grégory

doi:10.1053/j.jvca.2015.10.010

Article (Scientific journals)

Hydroxyethyl Starch 130/0.4 and the Risk of Acute Kidney Injury After Cardiopulmonary Bypass: A Single-Center Retrospective Study.

LAGNY, Marc-Gilbert; ROEDIGER, Laurence; KOCH, Jean-Noël et al.

2015 • In Journal of Cardiothoracic and Vascular Anesthesia

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/196093

DOI
10.1053/j.jvca.2015.10.010

PubMed
26774199

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Keywords :

Hydroxyethyl starch; acute kidney injury; cardiac surgery

Abstract :

[en] Hydroxyethyl Starches (HES) have been shown to increase the risk of acute kidney injury (AKI) in intensive care unit patients suffering sepsis. Whether this risk also applies to patients undergoing elective surgery remains unclear. We investigated whether HES is associated with acute kidney injury after on-pump cardiac surgery. Materials and Methods: Balanced HES 130/0.4 (Volulyte®, Fresenius Kabi AG, Bad Homburg, Germany) was used as a pump prime and for intraoperative fluid therapy until July 2013 and has been entirely replaced by a balanced crystalloid solution (Plasmalyte®, Baxter, Lessines, Belgium) from August 2013. Data from 697 adult patients undergoing cardiac surgery between April 2013 and June 2014 were reviewed. HES patients were propensity-matched on previously published risk factors for AKI after cardiac surgery to patients treated with crystalloids. Postoperative AKI was defined as the primary outcome and assessed using the Acute Kidney Injury Network classification. A conditional logistic regression was used to investigate the association between the use of HES and postoperative AKI. Secondary outcomes included renal function at postoperative day 7, 30-day mortality, lengths of ICU and hospital stays and the incidence of postoperative respiratory complications. Results and Discussion: One hundred and thirty HES patients were successfully matched with 130 crystalloids patients. HES was significantly associated with postoperative AKI (odds ratio=2.4; 95 % CI= 1.2-4.8; P=0.02). No significant association was found between HES and any of the secondary outcomes. Conclusion: This study suggests that using balanced HES 130/0.4 as a pump prime and for intraoperative fluid therapy in adult patients undergoing on-pump cardiac surgery is associated with a higher incidence of AKI during the early postoperative period.

Disciplines :

Anesthesia & intensive care

Author, co-author :

LAGNY, Marc-Gilbert ; Centre Hospitalier Universitaire de Liège - CHU > Bloc opératoire chirurgie cardio-vasculaire (+1BC)

ROEDIGER, Laurence ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anesthésie - réanimation

KOCH, Jean-Noël ; Centre Hospitalier Universitaire de Liège - CHU > Bloc opératoire chirurgie cardio-vasculaire (+1BC)

DUBOIS, Fanny ; Centre Hospitalier Universitaire de Liège - CHU > Département de pharmacie hospitalière

SENARD, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anesthésie - réanimation

Donneau, Anne-Françoise ; Université de Liège > Département des sciences de la santé publique > Biostatistique

HUBERT, Marie-Bernard ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anesthésie - réanimation

HANS, Grégory ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anesthésie - réanimation

Language :

English

Title :

Hydroxyethyl Starch 130/0.4 and the Risk of Acute Kidney Injury After Cardiopulmonary Bypass: A Single-Center Retrospective Study.

Publication date :

19 October 2015

Journal title :

Journal of Cardiothoracic and Vascular Anesthesia

ISSN :

1053-0770

eISSN :

1532-8422

Publisher :

W.B. Saunders, Philadelphia, United States - Pennsylvania

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 27 April 2016

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