Volume replacement therapy during major orthopedic surgery using Voluven® (Hydroxyethyl starch 130/0.4) or hetastarch

Sweeta D. Gandhi, Richard B. Weiskopf, Cornelius Jungheinrich, Robert Koorn, Diane Miller, Robert E. Shangraw, Donald S. Prough, Daniela Baus, Frank Bepperling, David C. Warltier

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

BACKGROUND: The purpose of this study was to test the equivalence of efficacy and compare the safety of the 6% hydroxyethyl starches (HES) Voluven® (HES 130/0.4; Fresenius Kabi, Bad Homburg, Germany) and hetastarch (HES 670/0.75 in saline) for intravascular volume replacement therapy during major orthopedic surgery. METHODS: In a prospective, controlled, randomized, double-blind, multicenter trial of patients undergoing major orthopedic surgery, 49 patients were treated with HES 130/0.4 and 51 patients were treated with hetastarch. Infusion of colloids was guided by central venous and arterial blood pressures. The primary efficacy endpoint was the volume of colloid solution infused; the primary safety endpoints were calculated total erythrocyte loss, the nadir factor VIII activity, and the nadir von Willebrand factor concentration within 2 h of completion of surgery. RESULTS: The total volume of colloid solution required for intraoperative volume replacement did not differ between HES 130/0.4 and hetastarch (1,613 ± 778 [SD] ml for HES 130/0.4 and 1,584 ± 958 ml for hetastarch). The nadir factor VIII activity within 2 h of the end of surgery was lower for hetastarch than for HES 130/0.4 (P = 0.0499); for those who received greater than 1,000 ml colloid, the nadir factor VIII activity and von Willebrand factor concentration within 2 h of end of surgery were lower for hetastarch than for HES 130/0.4 (P = 0.0487 and P = 0.008, respectively). CONCLUSION: Voluven® (HES 130/0.4) and hetastarch are equally efficacious plasma volume substitutes; however, HES 130/0.4 has a lesser effect on coagulation.

Original languageEnglish (US)
Pages (from-to)1120-1127
Number of pages8
JournalAnesthesiology
Volume106
Issue number6
DOIs
StatePublished - Jun 1 2007

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Gandhi, S. D., Weiskopf, R. B., Jungheinrich, C., Koorn, R., Miller, D., Shangraw, R. E., Prough, D. S., Baus, D., Bepperling, F., & Warltier, D. C. (2007). Volume replacement therapy during major orthopedic surgery using Voluven® (Hydroxyethyl starch 130/0.4) or hetastarch. Anesthesiology, 106(6), 1120-1127. https://doi.org/10.1097/01.anes.0000265422.07864.37