- 作者：Robert S. Green ; MD ; DABEM ; FRCPC ; FRCP(Edin)* ; &dagger ; ; greenrs@dal.ca" class="auth_mail" title="E-mail the corresponding author ; Michael B. Butler ; MD(Candidate) ; MSc&Dagger ; ; Shawn D. Hicks ; MD ; MSc§ ; ; Mete Erdogan ; PhD ; MHI&dagger ;
- 关键词：vascular ; surgery ; colloid ; hydroxyethyl starch (HES) ; outcomes
- 刊名：Journal of Cardiothoracic and Vascular Anesthesia
- 出版年：2016
- 出版时间：August 2016
- 年：2016
- 卷：30
- 期：4
- 页码：967-972
- 全文大小：272 K
Design
Retrospective case series.
Setting
Single-center academic hospital.
Participants
The study included 1,395 adult vascular surgery patients with peripheral vascular disease.
Interventions
Retrospective review of hospital databases.
Measurements and Main Results
Outcomes were compared between patients who were intraoperatively administered HES (Voluven [Fresenius Kabi, Bad Homburg, Germany] or Pentaspan [Bristol-Myers Squibb Canada, Montreal, Quebec, Canada]) versus patients who received only crystalloids during their procedure. Logistic regression was used to assess for association between these groups and mortality (in-hospital, 30-day), intensive care unit admission, hemodialysis requirement, vasopressor requirement, and ventilator requirement. Overall, 796 patients had complete fluid records and were included in the analysis. After adjustment for potential confounders, receiving an HES solution was associated with increased likelihood of 30-day mortality (odds ratio [OR] 2.11, 95% confidence interval [CI] 1.05-3.80), postoperative requirement for hemodialysis (OR 6.17, 95% CI 1.09-35.10), intensive care unit admission (OR 3.52, 95% CI 2.15-5.74), and mechanical ventilation (OR 3.16, 95% CI 1.84-5.41).
Conclusions
Intraoperative administration of HES was associated with an increased likelihood of adverse outcomes compared with use of crystalloids alone.