{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:36:37Z","timestamp":1785418597578,"version":"3.56.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:00:00Z","timestamp":1581984000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Whether third\u2010generation hydroxyethyl starch solutions provoke kidney injury or haemostatic abnormalities in patients having cardiac surgery remains unclear. We tested the hypotheses that intra\u2010operative administration of a third\u2010generation starch does not worsen postoperative kidney function or haemostasis in cardiac surgical patients compared with human albumin 5%. This triple\u2010blind, non\u2010inferiority, clinical trial randomly allocated patients aged 40\u201385 who underwent elective aortic valve replacement, with or without coronary artery bypass grafting, to plasma volume replacement with 6% starch 130\/0.4 vs. 5% human albumin. Our primary outcome was postoperative urinary neutrophil gelatinase\u2010associated lipocalin concentrations, a sensitive and early marker of postoperative kidney injury. Secondarily, we evaluated urinary interleukin\u201018; acute kidney injury using creatinine\n                    <jats:styled-content style=\"fixed-case\">RIFLE<\/jats:styled-content>\n                    criteria, coagulation measures, platelet count and function. Non\u2010inferiority (delta 15%) was assessed with correction for multiple comparisons. We enrolled 141 patients (69 starch, 72 albumin) as planned. Results of the primary analysis demonstrated that postoperative urine neutrophil gelatinase\u2010associated lipocalin (median (\n                    <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                    [range])) was slightly lower with hydroxyethyl starch (5 (1\u201368 [0\u2013996]) ng.ml\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) vs. albumin (5 (2\u201374 [0\u20131604]) ng.ml\n                    <jats:sup>\u22121<\/jats:sup>\n                    ), although not non\u2010inferior [ratio of geometric means (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    ) 0.91 (0.57, 1.44); p\u00a0=\u00a00.15] due to higher than expected variability. Urine interleukin\u201018 concentrations were reduced, but interleukin\u201018 and kidney injury were again not non\u2010inferior. Of 11 individual coagulation measures, platelet count and function, nine were non\u2010inferior to albumin. Two remaining measures, thromboelastographic R value and arachidonic acid\u2010induced platelet aggregation, were clinically similar but with wide confidence intervals. Starch administration during cardiac surgery produced similar observed effects on postoperative kidney function, coagulation, platelet count and platelet function compared with albumin, though greater than expected variability and wide confidence intervals precluded the conclusion of non\u2010inferiority. Long\u2010term mortality and kidney function appeared similar between starch and albumin.\n                  <\/jats:p>","DOI":"10.1111\/anae.14994","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T02:46:22Z","timestamp":1582080382000},"page":"1180-1190","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effect of 6% hydroxyethyl starch 130\/0.4 on kidney and haemostatic function in cardiac surgical patients: a randomised controlled trial"],"prefix":"10.1111","volume":"75","author":[{"given":"A. E.","family":"Duncan","sequence":"first","affiliation":[{"name":"Departments of Cardiothoracic Anesthesiology and Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Soltesz","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.O.","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Mao","sequence":"additional","affiliation":[{"name":"Departments of Quantitative Health Sciences and Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Timur","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Kottke\u2010Marchant","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Administration Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. J.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ma","sequence":"additional","affiliation":[{"name":"Departments of Quantitative Health Sciences and Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ince","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Yagar","sequence":"additional","affiliation":[{"name":"Department of Outcomes Research Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Trombetta","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Anesthesiology Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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