Volume expansion with hydroxymethylamide (voluven 6%) in the immediate postoperative period after heart surgery

Objective

To analyze the usage of hydroxymethylamide during volume reposition in the immediate postoperative period after heart surgery.

Materials and methods

A prospective study in which patients submitted to heart surgery had volume expansion with voluven 6%. Only patients with total preserved renal and hepatic function were included. None of them had any clinical or laboratorial signs of coagulation disturbances or any occurrence during surgical procedure. Voluven 6% was used during the initial phase of the postoperative period (first 2 hours), with a maximum volume limit of 1000 ml per patient. Other aspects were studied such as signs of bleeding, anaphylactic reactions and time for achieving clinical stability.

Results

A total of 192 patients were analyzed; 71.3% were male. Regarding the type of surgery, 77.08% were submitted to CABG, 15.10% to valve surgeries and 7.82% to other types of interventions (congenital heart disease, aortic aneurysm, etc.). The time necessary for hemodynamic stability during infusion was about 60 min and the total bleeding amount was considered acceptable (547 ml in 24 hours). Three patients (5.73%) evolved to bleeding related to coagulation disturbances caused by temporary CPB, which justified blood transfusions. There were no significant alterations in relation to hematocrit and hemoglobin levels, or to platelet counting. No pyrogenic or anaphylactic reactions were detected during the study.

Conclusion

We believe the solution of hydroxymethylamide 6% is a safe and adequate volume expander for use during the recovery phase of patients submitted to heart surgery.