TITLE

A hyperosmolar-colloidal additive to the CPB-priming solution reduces fluid load and fluid extravasation during tepid CPB

AUTHOR(S)
Kvalheim, V.; Farstad, M.; Haugen, O.; Brekke, H.; Mongstad, A.; Nygreen, E.; Husby, P.
PUB. DATE
January 2008
SOURCE
Perfusion;Jan2008, Vol. 23 Issue 1, p57
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Cardiopulmonary bypass(CPB) is associated with fluid overload. We hypothesized that fluid gain during CPB could be reduced by substituting parts of a crystalloid prime with 7.2% hypertonic saline and 6% poly(O2-hydroxyethyl) starch solution (HyperHaes®). 14 animals were randomized to a control group (Group C) or to Group H. CPB-prime in Group C was Ringer's solution. In group H, 4 ml/kg of Ringer's solution was replaced by the hypertonic saline / hydroxyethyl starch solution. After 60 mm stabilization, CPB was initiated and continued for 120 mm. All animals were allowed drifting of normal temperature (39.0°C) to about 35.0°C. Fluid was added to the CPB circuit as needed to maintain a 300-ml level in the venous reservoir. Blood chemistry, hemodynamic parameters, fluid balance, plasma volume, fluid extravasation rate (FER), tissue water content and acid-base parameters were measured/calculated. Total fluid need during 120 mill CPB was reduced by 60% when hypertonic saline/hydroxyethyl starch solution was added to the CPB prime (p<0.01). The reduction was related to a lowered FER. The effect was most pronounced during the first 30 mm on CPB, with 0.6 (0.43) (Group H) compared with 1.5 (0.40) ml/kg/min (Group C) (p<0.01). Hemodynamics and laboratory parameters were similar in both groups. Serum concentrations of sodium and chloride increased to maximum levels of 148 (1.5) and 112 (1.6) mmol/l in Group H. To conclude: addition of 7.2% hypertonic saline and 6% poly(O-2-hydroxyethyl) starch solution to crystalloid CPB prime reduces fluid needs and FER during tepid CPB.
ACCESSION #
34264829

 

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