Background: The use of hetastarch during coronary
bypass surgery has been limited due to its unresolved potential
risk for hemorrhage. Therefore, the purpose of this study was to
investigate the effects of using 6% hetastarch in priming
cardiopulmonary bypass (CPB) circuitry on the need for blood product
transfusions and outcome after coronary bypass.
and methods: This nonrandomized retrospective study involved 887
patients who underwent isolated primary coronary artery bypass
grafting. Based on the type of solution used in priming the CPB
circuitry, patients were stratified into the following four different
groups: group 1, crystalloid (500 mL; n = 211); group 2, 25% human
albumin (50 mL; n = 217); group 3, 6% hetastarch (500 mL;
n = 298); and group 4, 25% human albumin (50 mL) and 6% hetastarch
(500 mL; n = 161). Patient characteristics and clinical
variables were compared among the groups using the Kruskal-Wallis test.
Patient survival estimates were compared using log-rank
Results: Demographic patient
characteristics for all groups were similar (p > 0.05).
Intraoperative and perioperative variables among groups were comparable
(p > 0.05). The use of hetastarch as a part of prime solution in CPB
circuitry did not alter the need for banked blood, platelets, or fresh
frozen plasma transfusions (p > 0.05). The length of stay in the ICU
or in the hospital was unaffected in all groups. The early
(ie, 30-day) mortality rate was 1.4% in group 1, 1.8%
in group 2, 1.0% in group 3, and 3.1% in group 4. Long-term survival
among the groups was unaffected by the type of priming solution.
Conclusions: The use of hetastarch in priming CPB circuitry
is devoid of any added hemorrhagic risk after coronary bypass, and the
type of prime solution for CPB has no influence on the early or late
survival rates of patients undergoing primary coronary