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Journal of Anesthesia
Published in: Journal of Anesthesia 5/2016

01-10-2016 | Original Article

Effects of hydroxyethyl starch 6 % (130/0.4) on blood loss during cesarean delivery: a propensity-matched analysis

Authors: Abdullah S. Terkawi, Sarah K. Larkin, Siny Tsang, Jessica S. Sheeran, Mohamed Tiouririne

Published in: Journal of Anesthesia | Issue 5/2016

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Abstract

Background

Hydroxyethyl starch is commonly used in the obstetric patient population to prevent hypotension during cesarean delivery. Evidence suggests hetastarch is associated with a dysfunction in coagulation cascade. We hypothesized that hetastarch use to prevent spinal hypotension during cesarean delivery would be associated with an increase in blood loss when compared to crystalloid use.

Methods

We performed a retrospective review of patients who underwent elective cesarean delivery under spinal anesthesia at the University of Virginia between 2011 and 2014. Data from 819 patients was used. Blood loss was the primary outcome. Propensity score-matching was used to match patients who received hetastarch (treatment group) with those who did not receive hetastarch (control group).

Results

Genetic matching resulted in 196 patients in the hetastarch group and 182 patients in the control group. There was no difference in estimated blood loss (p = 0.068), calculated blood loss (p = 0.720), total intraoperative fluid intake (p = 0.289), urine output (p = 0.421), Apgar 1 min (p = 0.830), Apgar 5 min (p = 0.138), phenylephrine consumption (p = 0.742), postoperative day 1 (POD1) hematocrit (p = 0.070) and POD1 platelets (p = 0.233). However, there was a statistically significant difference (but clinically irrelevant) in hematocrit difference between the day of admission and POD1 (mean difference 0.47, p = 0.024), and ephedrine consumption (mean difference 2 mg, p = 0.017) in favor of the control group.

Conclusions

Our study did not find an association between increased perioperative blood loss and hetastarch use in patients presenting for elective cesarean delivery.
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Metadata
Title
Effects of hydroxyethyl starch 6 % (130/0.4) on blood loss during cesarean delivery: a propensity-matched analysis
Authors
Abdullah S. Terkawi
Sarah K. Larkin
Siny Tsang
Jessica S. Sheeran
Mohamed Tiouririne
Publication date
01-10-2016
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 5/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-016-2208-z

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