Canadian Journal of Anesthesia

, 47:1207 | Cite as

A novel hydroxyethyl starch (Voluven®) for effective perioperative plasma volume substitution in cardiac surgery

  • R. C. G. Gallandat Huet
  • A. W. Siemons
  • D. Baus
  • W. T. van Rooyen-Butijn
  • J. A. M. Haagenaars
  • W. van Oeveren
  • F. Bepperling
Reports of Investigation


Purpose: To compare the new hydroxyethyl starch HES 130/0.4 (Voluven®) and the standard HES 200/0.5 (pentastarch) regarding effectiveness for plasma volume substitution and safety of large volumes in heart surgery.

Methods: Fifty-nine patients scheduled for coronary artery bypass grafting were enrolled in a prospective, randomised, double-blind, parallel-group, multicentre, clinical, phase III study. Hydroxyethyl starch was used as the exclusive artificial colloid for acute normovolemic hemodilution, priming of the heart lung machine, and for intra- and postoperative plasma volume substitution from induction of anesthesia until 16 hr after the end of surgery. Efficacy was evaluated by comparing the amount of colloid infused, hemodynamics, and colloid osmotic pressure (COP). Safety endpoints were blood loss, the use of allogeneic blood products, coagulation variables, and adverse events.

Results: Effectiveness, as assessed by the total amount of infused HES volumes within the treatment period, was similar between HES 130/0.4 and HES 200/0.5 (2550 mL±560 mL vs 2466 mL ±516 mL). Also, no differences were found for the use of other colloids (pasteurised plasma), hemodynamics, and COP. In HES 130/0.4 patients, the postoperative increase of von-Willebrand factor (vWF) was higher (P<0.01), blood loss was lower, and less packed red blood cells were transfused.

Conclusion: Hydroxyethyl starch 130/0.4 is an effective plasma volume expander in heart surgery and may be used as the sole artificial colloid to cover the perioperative period. We found a reduced influence of HES 130/0.4 on the physiologic postoperative increase of vWF.


Objectif: Comparer le nouvel hydroxyéthylamidon HEA 130/0,4 (Voluven®) et l’HEA standard 200/0,5 (pentamidon) au plan de l’efficacité, quand on l’utilise comme substitution du volume plasmatique, et au plan sécuritaire de l’emploi de volumes importants en cardiochirurgie.

Méthode: Cinquante-neuf patients qui devaient subir un pontage aorto-coronarien ont participé à une étude clinique multicentrique, prospective, randomisée, à double insu et en groupes parallèles, de phase Ill. L’hydroxyéthylamidon a été utilisé comme colloïde artificiel exclusif pour l’hémodilution normovolémique pratiquée d’emblée, pour amorcer l’utilisation du coeur-poumon artificiel et pour le remplacement du volume plasmatique peropératoire et postopératoire depuis l’induction de l’anesthésie jusqu’à 16 h après la fin de l’opération. L’efficacité a été évaluée en comparant la quantité de colloïde perfusé, l’hémodynamie et la pression osmotique du colloïde (POC). Les paramètres mesurés ont été: la perte sanguine, l’utilisation de produits sanguins allogéniques, les variables de coagulation et les inconvénients.

Résultats: L’efficacité, évaluée selon la quantité totale d’HEA perfusé pendant le traitement, a été similaire pour l’HEA 130/0,4 et l’HEA 200/0,5 (2550 mL±561 mL vs 2466 mL±516 mL). De plus, il n’y a eu aucune différence quant à l’utilisation d’autres colloïdes (plasma pasteurisé), à l’hémodynamie et à la POC. Chez les patients qui ont reçu l’HEA 130/0,4, l’augmentation postopératoire du facteur de von Willebrand (vWF) a été plus élevée (P<0,01), la perte sanguine plus faible et la transfusion de globules rouges concentrés moins importante.

Conclusion: L’hydroxyéthylamidon 130/0,4 représente un substitut du plasma sanguin efficace en cardiochirurgie et peut être utilisé comme colloïde artificiel unique pendant la période périopératoire complète. Nous avons constaté une action réduite de l’HEA 130/0,4 sur l’augmentation physiologique postopératoire du vWF.


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Copyright information

© Canadian Anesthesiologists 2000

Authors and Affiliations

  • R. C. G. Gallandat Huet
    • 4
  • A. W. Siemons
    • 2
  • D. Baus
    • 3
  • W. T. van Rooyen-Butijn
    • 2
  • J. A. M. Haagenaars
    • 4
  • W. van Oeveren
    • 1
  • F. Bepperling
    • 3
  1. 1.Department of Biomedical EngineeringUniversity Hospital GroningenThe Netherlands
  2. 2.Department of Thoracic Anesthesiology and Intensive CareHospital De WeezenlandenZwolleThe Netherlands
  3. 3.Fluid Therapy DivisionFresenius Kabi Deutschland GmbHBad HomburgGermany
  4. 4.Department of AnesthesiologyUniversity Hospital GroningenGroningenThe Netherlands

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