Comparison of Low Molecular Weight Hydroxyethyl Starch and Human Albumin as Priming Solutions in Children undergoing Cardiac Surgery

Human albumin is the conventional cardiopulmonary bypass circuit primer.
However, it has high manufacturing costs. Crystalloid and colloid
solutions have been developed as alternatives, including a new
generation of non-ionic hydroxyethyl starch (HES). The efficacy of
hydroxyethyl starch with a 130 molecular weight and substitution degree
of 0.4 (hydroxyethyl starch 130/0.4) was compared with human albumin for
use in cardiopulmonary bypass surgery in American Society of
Anesthesiologists’ grade I-II pediatric congenital heart disease
patients. Efficacy was evaluated by comparing perioperative hemodynamic
parameters, including plasma colloid osmotic pressure, renal function,
blood loss, allogeneic blood volumes and plasma volume substitution. The
hydroxyethyl starch group exhibited significantly higher preoperative
colloid osmotic pressure (p<0.01) and significantly lower operative renal function and postoperative allogeneic blood volumes than the human albumin group. No significant differences were observed in serum creatinine, glucose, hematocrit or lactic acid levels (p>0.05). Our
results indicate that hydroxyethyl starch may be a viable alternative to
human albumin in pediatric patients undergoing relatively simple
cardiopulmonary bypass surgeries.