S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) Theses (Ph.D. / Sc.D._의학과)
The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery
심장 수술을 받는 어린이에서 Hydroxyethyl starch 사용이 수술 후 급성 신장 손상 발생에 주는 영향
- 의과대학 의학과
- Issue Date
- 서울대학교 대학원
- congenital heart disease; crystalloid vs colloid; paediatrics; renal failure; cardiopulmonary bypass; surgery
- 학위논문 (박사)-- 서울대학교 대학원 : 의과대학 의학과, 2018. 2. 김진태.
- 19.6% vs. 21.1%, P = 0.602 using AKIN). There were no differences in clinical outcomes such as mortality, major adverse events, length of intensive care unit stay or duration of mechanical ventilation. Clotting time on the external TEMogram was more prolonged, and clot firmness after 10 min and maximal clot firmness on the fibrinogen TEMogram were shorter in the HES group compared with the control group after sternal closure. However, there was no difference in the transfusion requirement between the two groups. Patients with AKI had worse clinical courses than those without AKI. We conclude that intra-operative use of 6% HES 130/0.4 up to 30 ml.kg-1 was not inferior to crystalloid in terms of the incidence of AKI in paediatric cardiac patients.
We have evaluated the effect of a colloid solution on acute kidney injury (AKI) in paediatric cardiac surgery. A total of 195 patients were randomly divided into an hydroxyethyl starch (HES) group and a control group. In the HES group, 6% HES 130/0.4 (Volulyte®) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg-1. In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of AKI, peri-operative transfusion, clinical outcomes and laboratory data were compared. The incidence of AKI determined by Paediatric Risk, Injury, Failure, Loss, End-stage renal disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria were no different between the two groups (HES group 40.8% vs control group 30.0%
p = 0.150 using pRIFLE