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首页> 外文期刊>Anaesthesia: Journal of the Association of Anaesthetists of Great Britain and Ireland >The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial
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The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial

机译：6％羟乙基淀粉（130 / 0.4）对儿科心脏手术急性肾损伤的影响：一种预期，随机试验

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摘要

We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte (R)) 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 acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared. The incidence of acute kidney injury 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 (starch group 40.8% vs. control group 30.0%; p = 0.150 using pRIFLE; 19.6% vs. 21.1% respectively, p = 0.602 using AKIN). There were no differences in clinical outcomes such as mortality, major adverse events, intensive care unit stay or duration of mechanical ventilation. Clotting time as measured using rotational thromboelastometry (ROTEM) was prolonged, and clot firmness after 10 min and maximal clot firmness were shorter in the starch group compared with the control group after sternal closure. There was no difference in transfusion between the two groups. Patients with acute kidney injury had worse clinical courses than those without acute kidney injury. We conclude that intra-operative use of 6% hydroxyethyl starch 130/0.4 up to 30 ml.kg(-1) was not associated with postoperative acute kidney injury in paediatric cardiac patients.
机译：我们已经评估了胶体溶液对小儿心脏手术急性肾损伤的影响。共有195名患者将Ramdomly分为羟乙基淀粉组和对照组。在淀粉组中，使用6％羟乙基淀粉130 / 0.4（Volulyte（r））作为体积复苏的初级流体，但仅限于30ml.kg（-1）。在对照组中，在PERI操作期间仅使用晶体流体。比较了急性肾损伤，PERI术输血，临床结果和实验室数据的发病率。通过儿科风险，损伤，失效，损失，末期肾病（PRIFLE）和急性肾损伤网络（类似）之间的急性肾损伤的发病率在两组之间没有差异（淀粉组40.8％对照组30.0％; P = 0.150使用牛仔; 19.6％与21.1％，P = 0.602使用类似）。临床结果没有差异，如死亡率，重大不良事件，重症监护单位住宿或机械通风持续时间。使用旋转血栓弹性测量法（Rotem）测量的凝血时间延长，并且在胸骨闭合后的对照组比较淀粉组10分钟后的凝块固体度和最大凝块的坚固性。两组之间输血没有差异。急性肾损伤的患者的临床课程比没有急性肾损伤的患者更差。我们得出结论，术中使用6％羟乙基淀粉130 / 0.4至30mL.kg（-1）与小儿心脏患者的术后急性肾损伤无关。

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