Intra-operative hydroxyethyl starch is not associated with post-craniotomy hemorrhage.
BACKGROUND
Intraoperative intravascular volume expansion with hydroxyethyl starch-based colloids is thought to be associated with an increased risk of post-craniotomy hemorrhage. Evidence for this association is limited. Associations between resuscitation with hydroxyethyl starch and risk of repeat craniotomy for hematoma evacuation were examined.


METHODS
Using a retrospective cohort of neurosurgical patients at Duke University Medical Center between March 2005 and March 2012, patient characteristics were compared between those who developed post-craniotomy hemorrhage and those who did not.


RESULTS
A total of 4,109 craniotomy procedures were analyzed with 61 patients having repeat craniotomy for post-operative hemorrhage (1.5%). The rate of reoperation in the group receiving 6% High Molecular Weight Hydroxyethyl Starch (Hextend(®)) was 2.6 vs. 1.3% for patients that did not receive hetastarch (P = 0.13). The reoperation rate for those receiving 6% hydroxyethyl Starch 130/0.4 (Voluven(®)) was 1.4 vs. 1.6% in patients not receiving Voluven (P = 0.85).


CONCLUSIONS
In this retrospective cohort, intra-operative hydroxyethyl starch was not associated with an increased risk of post-craniotomy hemorrhage.
['Feix|James A|JA|', 'Peery|C Andrew|CA|', 'Gan|Tong J|TJ|', 'Warner|David S|DS|', 'James|Michael L|ML|', 'Zomorodi|Ali|A|', 'McDonagh|David L|DL|']
Hydroxyethyl starch Hemorrhage Colloid Craniotomy Neuroanesthesia Neurosurgery