BACKGROUND: Hydroxyethyl starch (HES) is used for intravascular volume expansion in cardiac surgery. Studies have produced conflicting data on the effects of intraoperative HES administration on postoperative bleeding. We evaluated the effects of intraoperative HES infusion, shortly after the termination of cardiopulmonary bypass (CPB), on hemostasis following a cardiac operation.

METHODS: According to a prospective, random sequence, 30 children undergoing cardiac surgery received one of the following; fresh frozen plasma (FFP)(n = 10), HES 130/0.4 (n = 10), or HES 200/0.5 (n = 10) shortly after CPB termination. Standard coagulation variables were measured using arterial blood samples.

RESULTS: While the use of allogenic blood/ blood products and aPTT did not differ significantly among the groups, blood loss during the 24 hours following surgery increased significantly in the HES 200 group and PT after fluid infusion increased in both HES groups.

CONCLUSIONS: Our study shows that the administration of moderate dose of HES (130/0.4) in children undergoing cardiac surgery did not cause more bleeding than FFP administration. Thus, this HES (130/0.4) solution appears to be a safe alternative plasma substitute for intravascular volume replacement in this patient population.