Background: This study compared the effects of a potato-based hydroxyethyl starch (HES) with those of a maize-derived HES preparation on coagulation in cardiac surgery patients.
Methods: Sixty patients undergoing elective cardiac surgery with cardiopulmonary bypass were allocated randomly to receive either a potato-derived HES (6% HES 130/0.42) (n=30) or a waxy-maize-derived HES (6% HES 130/0.4) (n=30) given to keep pulmonary capillary wedge pressure/central venous pressure between 12 and 14 mm Hg until the second postoperative day (POD). A four-channel thrombelastography analyzer was used to measure rotation thrombelastometry (ROTEM) and whole blood aggregometry was used to assess the effects on platelet function.
Results: Potato HES 2990 (340) ml and maize HES 2890 (350) ml were given on the second POD. Standard coagulation (e.g. fibrinogen and antithrombin III) did not differ between the groups. Blood loss and need for transfusion of blood/blood products did not differ. Coagulation time (intrinsic/extrinsic CT) and clot formation time (intrinsic/extrinsic CFT) increased similarly after surgery and after 5 h, but recovered completely by the first and second POD. Clot firmness was similar in both groups. Platelet function induced by three inductors decreased significantly after surgery, but without significant differences between the two groups. Platelet function had recovered fully by the first POD.
Conclusions: Both HES preparations showed similar effects on thrombelastometry and platelet function. As blood loss and need for the use of blood products were also similar, both potato- and maize-derived HES preparations can be safely used in cardiac surgery with regard to haemostasis.