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

Abstract

Aim: Colloids are effective in volume resuscitation but they have been shown to have negative impacts on fibrin formation. Theaim of this study is to evaluate the effect of using low dose HES solutions on fibrinogen level in cesarean operations.Material and Method: 100 women, scheduled for cesarean surgery with spinal anesthesia were enrolled in the study. Patientswere 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 HESreceived 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 was276±58 mL for Group HES and 1197±197 mL for Group RL. There was a significant change in haemoglobin and fibrinogenvalues before and after surgery between groups. The mean decrease in fibrinogen was 92.18±60.12 mg/dL in Group HES and65.70±83.61 mg/dL in Group RL.Conclusion: HES 130/0.4 solution can be used in elective cesarean operations without predicted or active hemorrhage. Whenthere is a hemorrhage of any reason in HES 130/0.4 used cases, the decrease in fibrinogen level must be anticipated and rapidreplacement of fibrinogen must be kept in mind.