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Intraoperative hydroxyethyl starch does not influence postoperative renal function in the parturients with severe preeclampsia undergoing cesarean section: A retrospective matched-pair analysis.
Abstract Number: T-34
Abstract Type: Original Research
Anesthesia for severe preeclampsia has been debated and fluid management is one of the important issues of anesthetic management in theses patients. In our institute, limited amount of 6% hydroxyethyl starch (HES) 70/0.5 has been administered for intraoperative fluid infusion for anesthesia in parturients with severe preeclampsia. However, HES has harmful effect on renal function in septic patients. There is no evidence that HES is either safe or harmful in women with preeclampsia with impaired kidney function. Therefore, we conducted this study to determine whether HES worsens renal function in patients with severe preeclampsia undergoing cesarean section.
After IRB approval, all medical and anesthesia records of the severe preeclamptic patients who received anesthesia for cesarean section from Janurary 2011 to December 2013 at our university hospital were reviewed using electronic database (severe preeclampsia group: S-PE group). In addition, a matched-pair control group was selected from the same database. Patients in the control group were matched for age and gestational weeks of delivery. Preoperative complete blood count and chemistry were compaired to postoperative values. The t-tests and the chi-square tests were used to compare numerical and nominal variables, respectively.
Among 3,705 patients, 87 parturients were included in the S-PE group and 86 parturients were selected as the control group. Amount of intraoperative HES in S-PE and control group were 859 ± 206 mL and 1063 ± 245 mL, respectively (p<0.001). Serum concentrations of creatinine, urea, and uric acid in S-PE group were significantly higher in all time points (Table. 1). The postoperative increase of creatinine from preoperative period to 48 hours postoperative period were not different in two groups.
There was no evidence that intraoperative 6% HES 70/0.5 less than 1,000 mL adversely affects kidney function during cesarean section in parturients with severe preeclampsia.