Effect of preoperative hypervolemic hemodilution with hydroxyethyl starch (130/0.4) on hemodynamics, blood loss and renal function after laparoscopic gastric bypass surgery

Background
In a trial to overcome the adverse effects of pneumoperitoneum during laparoscopic gastric bypass surgery (GBP) on renal function this study investigated the effects of third generation HES 130/0.4 (6%) on renal function and blood loss during laparoscopic GBP.
Patients and methods
This study was carried out on 83 adult patients of both sexes scheduled for (GBP) surgery. Patients were randomly classified into Group I (42): received HES 130/0.4 10 ml/kg to a maximum volume 1000 ml, and Group II (41): received ringer acetate solution 10 ml/kg to a maximum volume 1000 ml within 30 min pre-operatively.
Results
Intraoperative and postoperative blood loss was comparable in both groups. Changes in mean arterial blood pressure (MABP), and heart rate (HR) were comparable in both groups except significant increase in MABP in group I from 30 min till 150 min intraoperatively ( values were 0.04, 0.03, 0.02, 0.04, 0.01, respectively). Creatinine clearance increased significantly at postoperative assessment time in group I, ( = 0.04). There was no significant difference between both groups regarding serum creatinine and blood urea. Intraoperative urine output significantly increased in group I, ( = 0.02).
Conclusion
Infusion of HES 130/0.4 has role in prevention of oliguria and provides renal protection without effect on hemostasis and intraoperative or postoperative blood loss.