Comparing the Efficacy of 6% Hydroxyethyl Starch 130/0.4 and Human Albumin for Intravenous Fluid Replacement in Pediatric Open-Heart Surgery

Background: Providing and maintaining normovolemic condition during major surgeries is a major challenge, especially in children. In this respect, third-generation hydroxyethyl starches seem to be more cost-effective than human albumin. However, the efficacy of 6% hydroxyethyl starch (HES) 130/0.4 compared to other alternatives such as human albumin 5% remains uncertain in children. The present study aimed to assess the efficacy and safety of replacing human albumin 5% with 6% HES 130/0.4 for volume replacement therapy in children undergoing selective open cardiac surgery. Method: This randomized double-blinded clinical trial was performed on 59 children aged less than 2 years and ASA I-III who were candidated for selective open-heart surgery and referred to a children medical center in 2014. The patients were randomly assigned via the block randomization method to the case group (n = 30) receiving a solution of 6% HES 130/0.4 and the control group (n = 29) receiving 5% human albumin. There were no between-group differences in hemodynamic parameters—including pulse rate, systolic and diastolic blood pressures, and mean blood pressure—at the time points of before anesthesia induction, before and after pump insertion, and 24 hours after surgery. Results: Comparisons of the laboratory indices indicated no differences between the 2 groups at the different time points. The volume of packed cell and colloid fluids infused in the case and control group was also similar. Conclusions: Compared to human albumin 5%, 6% HES 130/0.4 is a safe alternative to fluid supply during cardiac surgery among children.