Background: The use of hetastarch during coronary bypass surgery has been l
imited due to its unresolved potential risk for hemorrhage. Therefore, the
purpose of this study was to investigate the effects of using 6% hetastarch
in priming cardiopulmonary bypass (CPB) circuitry on the need for blood pr
oduct transfusions and outcome after coronary bypass.
Materials and methods: This nonrandomized retrospective study involved 887
patients who underwent isolated primary coronary artery bypass grafting. Ba
sed on the type of solution used in priming the CPB circuitry, patients wer
e stratified into the following four different groups: group 1, crystalloid
(500 mL; n = 211); group 2, 25% human albumin (50 mL; n = 217); group 3, 6
% hetastarch (500 mL; n = 298); and group 4, 25% human albumin (50 mL) and
6% hetastarch (500 mL; n = 161). Patient characteristics and clinical varia
bles were compared among the groups using the Kruskal-Wallis test. Patient
survival estimates were compared using log-rank test.
Results: Demographic patient characteristics for all groups were similar (p
> 0.05). Intraoperative and perioperative variables among groups were comp
arable (p > 0.05). The use of hetastarch as a part of prime solution in CPB
circuitry did not alter the need for banked blood, platelets, or fresh fro
zen plasma transfusions (p > 0.05). The length of stay in the ICU or in the
hospital was unaffected in all groups. The early (ie, 30-day) mortality ra
te was 1.4% in group 1, 1.8% in group 2, 1.0% in group 3, and 3.1% in group
4. Long-term survival among the groups was unaffected by the type of primi
ng solution.
Conclusions: The use of hetastarch in priming CPB circuitry is devoid of an
y added hemorrhagic risk after coronary bypass, and the type of prime solut
ion for CPB has no influence on the early or late survival rates of patient
s undergoing primary coronary bypass.