Perioperative volume replacement in children undergoing cardiac surgery: albumin versus hydroxyethyl starch 130/0.4.

This is a prospective randomized study in 119 consecutive children (weight 4.7-35 kg) undergoing correction of their congenital heart disease necessitating cardiopulmonary bypass. Patients received 50 mL/kg intraoperatively of either 4% albumin or 6% HES 130/0.4. Both groups of children were highly comparable concerning demographic and laboratory data. No difference between the groups was found for calculated blood loss and postoperative outcome. However, a higher number of patients in the albumin group needed allogeneic blood transfusions. Intraoperative fluid balance was significantly lower in the HES group. In the absence of HES-related side effects, the authors conclude that HES 130/0.4 may represent an interesting alternative to 4% albumin for intraoperative fluid volume replacement because of its lower cost.

– Konrad Messmer