Comparison of hydroxyethylstarch 130/0.4 and ringer’s lactate on fibrinogen level in caesarean operations: a randomized clinical trial

Abstract

COMPARISON OF HYDROXYETHYLSTARCH 130/0.4 AND RINGER’S LACTATE ON FIBRINOGEN LEVEL IN CAESAREAN OPERATIONS: A RANDOMIZED CLINICAL TRIAL Background and Aim: Colloids are effective in volume resuscitation but they have been shown to have negative impacts on fibrin formation. The aim of this study is to evaluate the effect of using low dose HES solutions on fibrinogen level in caserean operations. Materials and methods: 100 women, scheduled for Caserean surgery with spinal anesthesia were enrolled in the study. Patients were assigned to receive hydroxyethyl starch (HES) 130/0.4 in addition to a basic infusion of Ringer’s lactate (RL) solution (GROUP HES) or exclusively RL solution throughout the intraoperative study period (GROUP RL). Patients in the Group HES received HES 130/0.4 8 ml.kg-1h-1 with RL solution 5 mL.kg-1.h-1 and Group RL received RL solution 20 mL kg-1.h-1. Fibrinogen, haemoglobin, platelet values were recorded preoperatively and at postoperative first hour. Results: HES 130/0.4 was used only in Group HES, amount consumed was 418 ± 90 mL. Ringer’s lactate consumption was 276 ± 58 mL for Group HES and 1197 ± 197 mL for Group RL. There was a significant change in haemoglobine and fibrinogen values before and after surgery between groups. The mean decrease in fibrinogen was 92.18 ±60.12 mg/dL in Group HES and 65.70 ± 83.61 mg/dL in Group RL. Conclusion: HES 130/0.4 solution can be used in elective Caeserean operations without predicted or active hemorrhage. When there is a hemorrhage of any reason in HES 130/0.4 used cases, the decrease in fibrinogen level must be anticipated and rapid replacement of fibrinogen must be kept in mind.

Keywords

• Fibrinogen
• Hydroxyethyl starch
• caesarean sections

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