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 Prough, Daniela Baus, Frank Bepperling, David C. Warltier

Research output: Contribution to journalArticle

80 Citations (Scopus)

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 2007

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Hydroxyethyl Starch Derivatives
Orthopedics
Colloids
Therapeutics
Factor VIII
HES 130-0.4
Starch
Plasma Substitutes
Safety
Venous Pressure
Plasma Volume

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Gandhi, S. D., Weiskopf, R. B., Jungheinrich, C., Koorn, R., Miller, D., Shangraw, R. E., ... 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

Volume replacement therapy during major orthopedic surgery using Voluven® (Hydroxyethyl starch 130/0.4) or hetastarch. / Gandhi, Sweeta D.; Weiskopf, Richard B.; Jungheinrich, Cornelius; Koorn, Robert; Miller, Diane; Shangraw, Robert E.; Prough, Donald; Baus, Daniela; Bepperling, Frank; Warltier, David C.

In: Anesthesiology, Vol. 106, No. 6, 06.2007, p. 1120-1127.

Research output: Contribution to journalArticle

Gandhi, SD, Weiskopf, RB, Jungheinrich, C, Koorn, R, Miller, D, Shangraw, RE, Prough, D, Baus, D, Bepperling, F & Warltier, DC 2007, 'Volume replacement therapy during major orthopedic surgery using Voluven® (Hydroxyethyl starch 130/0.4) or hetastarch', Anesthesiology, vol. 106, no. 6, pp. 1120-1127. https://doi.org/10.1097/01.anes.0000265422.07864.37
Gandhi, Sweeta D. ; Weiskopf, Richard B. ; Jungheinrich, Cornelius ; Koorn, Robert ; Miller, Diane ; Shangraw, Robert E. ; Prough, Donald ; Baus, Daniela ; Bepperling, Frank ; Warltier, David C. / Volume replacement therapy during major orthopedic surgery using Voluven® (Hydroxyethyl starch 130/0.4) or hetastarch. In: Anesthesiology. 2007 ; Vol. 106, No. 6. pp. 1120-1127.
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T1 - Volume replacement therapy during major orthopedic surgery using Voluven® (Hydroxyethyl starch 130/0.4) or hetastarch

AU - Gandhi, Sweeta D.

AU - Weiskopf, Richard B.

AU - Jungheinrich, Cornelius

AU - Koorn, Robert

AU - Miller, Diane

AU - Shangraw, Robert E.

AU - Prough, Donald

AU - Baus, Daniela

AU - Bepperling, Frank

AU - Warltier, David C.

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N2 - 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.

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