TY - JOUR
T1 - Association between intraoperative starch use and postoperative kidney dysfunction in patients undergoing major gastro-intestinal surgery
T2 - A propensity score–matched analysis
AU - Iyer, Karthik V.
AU - Giri, Sanjeeb
AU - Ray, Bikash R.
AU - Muthiah, Thilaka
AU - Anand, Rahul K.
AU - Kaur, Manpreet
AU - Kumar, Rakesh
AU - Punj, Jyotsna
AU - Rewari, Vimi
AU - Sahni, Peush
AU - Maitra, Souvik
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Background: The impact of intraoperative starch-based fluid therapy on postoperative kidney dysfunction in patients undergoing major abdominal surgery is uncertain. Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the impact of intraoperative 6% hydroxyethyl starch on postoperative renal dysfunction. The primary outcome of this study was postoperative acute kidney injury as per KDIGO definition within 72 hours of surgery. Results: This study analysed data from 461 patients with a median (interquartile range) age of 45 (33–58) years, and 48.2% of all patients were female. The proportion (95% confidence interval) of patients who developed acute kidney injury was 0.18 (0.14−0.21); 62.9% of patients had acute kidney injury stage I, 32% had acute kidney injury stage II, and the rest were acute kidney injury stage III. In the propensity score–matched sample, the average treatment effect of intraoperative colloid use on postoperative serum creatinine at day 3 (p = 0.32), duration of postoperative intensive care unit stay (p = 0.97), duration of hospital stay (p = 0.37), postoperative worst international normalised ratio (p = 0.92), and postoperative transfusion requirement (p = 0.40) were not statistically significant. Conclusion: Intraoperative use of low molecular weight hydroxyethyl starch use was not associated with postoperative kidney dysfunction and coagulopathy in adult patients undergoing major open abdominal surgery.
AB - Background: The impact of intraoperative starch-based fluid therapy on postoperative kidney dysfunction in patients undergoing major abdominal surgery is uncertain. Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the impact of intraoperative 6% hydroxyethyl starch on postoperative renal dysfunction. The primary outcome of this study was postoperative acute kidney injury as per KDIGO definition within 72 hours of surgery. Results: This study analysed data from 461 patients with a median (interquartile range) age of 45 (33–58) years, and 48.2% of all patients were female. The proportion (95% confidence interval) of patients who developed acute kidney injury was 0.18 (0.14−0.21); 62.9% of patients had acute kidney injury stage I, 32% had acute kidney injury stage II, and the rest were acute kidney injury stage III. In the propensity score–matched sample, the average treatment effect of intraoperative colloid use on postoperative serum creatinine at day 3 (p = 0.32), duration of postoperative intensive care unit stay (p = 0.97), duration of hospital stay (p = 0.37), postoperative worst international normalised ratio (p = 0.92), and postoperative transfusion requirement (p = 0.40) were not statistically significant. Conclusion: Intraoperative use of low molecular weight hydroxyethyl starch use was not associated with postoperative kidney dysfunction and coagulopathy in adult patients undergoing major open abdominal surgery.
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U2 - 10.1177/17504589231174967
DO - 10.1177/17504589231174967
M3 - Article
C2 - 37646441
AN - SCOPUS:85169686291
SN - 1750-4589
VL - 35
SP - 14
EP - 21
JO - Journal of perioperative practice
JF - Journal of perioperative practice
IS - 1-2
ER -