Efficacy, and safety of 6% hydroxyethyl starch 130/0.4 to albumin in post-operative patients following pancreaticoduodenectomy

Abstract

Objective: This study was the efficacy, and safety of administering hydroxyethyl starch 6% 130/0.4 versus 5% albumin in patients undergoing pancreaticoduodenectomy. Background: Hypovolemia often occurs in patients undergoing extensive abdominal surgery. We hypothesized that 6% hydroxyethyl Starch (HES) 130/0.4 is equally efficacious and safe, compared to albumin and has added advantages such as low cost, disease-free transmission, and ready availability. Methods: Eligible adult patients were assigned following their surgery into either the HES 130/0.4 or the albumin group (n = 25 in each group). Crystalloids for hydration and colloid therapy for volume support were administered. The primary endpoint of the study was the hemodynamics. Secondary endpoints were efficacy and safety assessed by physical and laboratory examination, adverse events, and hospital courses. Results: The HES group had a lower average heart rate (83.7 beats/min vs. 89.5 beats/min; p = 0.017) and showed no differences in MAP compared to the albumin group. In addition, the HES group maintained higher hematocrit (30.9% vs. 27.6%; p = 0.02), whereas the albumin group showed prolonged activated partial thromboplastin time during the first 24 h following surgery (38.6 s vs. 42.9 s; p = 0.017). Other laboratory values and hospital courses were comparable in the two groups. However, the mean cost of the colloids was significantly lower in the HES group than in the albumin group (462,176 Won vs. 106,459 Won; p < 0.001). Conclusions: This study showed that 6% HES 130/0.4 is a more appropriate fluid strategy in post-operative patients following extensive abdominal surgery without sepsis.