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Master Thesis

Effet de l'Hydroxyéthylamidon 6% 130/0,4 sur la fonction rénale après chirurgie cardiaque

Abstract : Background: Acute renal failure (ARF) following cardiac surgery is a severe complication, associated with significant morbidity and mortality. The renal impact of hydroxyethylstarch (HES) is at present controversial. We evaluated retrospectively the renal risk of using HES 6% 130/0,4 (Voluven®, Fresenius-Kabi, Germany) in a cohort of 597 adult patients who underwent cardiac surgery. Methods: We studied all patients who underwent cardiac surgery from January 2008 to March 2009. We recorded the perioperative risk factors of ARF and the volume of HES administered until the end of the first postoperative day. Renal dysfunction was defined by a rise of 50% in creatinine within three days following surgery or the need of renal replacement therapy. Multivariate analysis was performed using logistic regression model to isolate the independent effect of HES on renal function. Using a propensity score, we matched two groups of patients, exposed and unexposed to a dose equal or greater than 15 ml/kg of HES. We compared the rates of creatinine between those two groups until the 10th day following surgery. Results: ARF developed in 61 patients (10.2%). Risk factors identified in univariate analysis were age, diuretic use, preoperative creatinine rate, left ventricular ejection fraction, valvular surgery, duration of surgical times, postoperative vasopressor or inotrope support, transfusion and emergent procedures. Patients with ARF received 15 ± 11 ml/kg of HES compared to 9 ± 3 ml/kg in patients without ARF (p<0,0001). The rates of creatinine in the two groups matched using a propensity score were similar until the 10th postoperative day. We did not find HES as an independent risk factor of ARF in multivariate analysis. Conclusion: In our study, HES 6% 130/0,4 is not an independent risk factor of ARF following cardiac surgery.
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Master Thesis
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Submitted on : Wednesday, May 2, 2012 - 1:20:47 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
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  • HAL Id : dumas-00693306, version 1

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Evodie Boully-Courtiol. Effet de l'Hydroxyéthylamidon 6% 130/0,4 sur la fonction rénale après chirurgie cardiaque. Médecine humaine et pathologie. 2012. ⟨dumas-00693306⟩

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