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

Kvalheim, V.; Farstad, M.; Haugen, O.; Brekke, H.; Mongstad, A.; Nygreen, E.; Husby, P.
January 2008
Perfusion;Jan2008, Vol. 23 Issue 1, p57
Academic Journal
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.


Related Articles

  • Effect of 6% Hydroxyethyl Starch 130/0.4 as a Priming Solution on Coagulation and Inflammation Following Complex Heart Surgery. Jang-Eun Cho; Jae-Kwang Shim; Jong-Won Song; Hye-Won Lee; Dong-Hwan Kim; Young-Lan Kwak // Yonsei Medical Journal;May2014, Vol. 55 Issue 3, p625 

    Purpose: Prolonged duration of cardiopulmonary bypass aggravates the degree of inflammation and coagulopathy. We investigated the influence of 6% hydroxyethyl starch (HES) 130/0.4 on coagulation and inflammation compared with albumin when used for both cardiopulmonary bypass priming and...

  • Clinical evaluation of the new BMU 40 in-line blood analysis monitor. Schaarschmidt, Jan; Seeburger, Joerg; Borger, Michael A.; Grosse, F. Oliver; Kraemer, Klaus; Mohr, Friedrich W. // Perfusion;Jul2009, Vol. 24 Issue 4, p277 

    Background: Accurate information about different blood parameters is essential in maintaining haemodynamics, perfusion and gas exchange during cardiopulmonary bypass (CPB). For this purpose, precise, accurate and continuous measurement and monitoring, preferably visually available, is needed....

  • Assessment of the hemodynamic changes following fluid preloading in cardiac surgery. Alsatli, Raed A. // Saudi Journal of Anaesthesia;Jan2012, Vol. 6 Issue 1, p56 

    Background: This prospective double-blind randomized study aims to study the hemodynamic changes following fluid preloading with Hydroxyethyl starch (HES) 6% (130/0.4) compared with normal saline (NS) in cardiac surgery patients. Methods: Forty patients undergoing coronary artery bypass grafting...

  • Very Early Extubation after Open-Heart Surgery in Children Does Not Influence Cardiac Function. Meißner, U.; Scharf, J.; Dötsch, J.; Schroth, M. // Pediatric Cardiology;Mar2008, Vol. 29 Issue 2, p317 

    The objective of our study was to evaluate hemodynamic effects and the cardiac function after very early extubation within the first 6 hours after open-heart surgery in children. During a 12-month period, we performed a retrospective study of 50 children (ages 3 months to 7 years) admitted to...

  • A model for cardiopulmonary bypass redesign. Groom, R.C.; Likosky, D.S.; Forest, R.J.; O'Connor, G.T.; Morton, J.R.; Ross, C.S.; Clark, C.; Kramer, R. // Perfusion;Jul2004, Vol. 19 Issue 4, p257 

    Introduction: A portion of patients undergoing cardiac surgery may develop focal and/or subtle brain injuries secondary to cardiac surgery. There is evidence that, in some cases, these injuries may be related to cardiopulmonary bypass (CPB). Embolism and hypoperfusion are the dominant mechanisms...

  • Changes in muscle compartment pressure after cardiopulmonary bypass. Símonardóttir, Líney; Torfason, Bjarni; Stefánsson, Einar; Magnússon, Jónas // Perfusion;May2006, Vol. 21 Issue 3, p157 

    Purpose: Hemodilution and inflammation lead to edema and increased muscle compartment pressure after cardiac surgery. The aim of this study was to find whether muscle compartment pressure was affected by the addition of albumin and mannitol to the pump prime, heparin coating or leukocyte...

  • Factors influencing the change in cerebral hemodynamics in pediatric patients during and after corrective cardiac surgery of congenital heart diseases by means of full-flow cardiopulmonary bypass. Abdul-Khaliq, H; Uhlig, R; Böttcher, W; Ewert, P; Alexi-Meskishvili, V; Lange, PE // Perfusion;May2002, Vol. 17 Issue 3, p179 

    Background: The pathophysiology of hypoxic-ischemic brain injury in relation to extracorporeal circulation is multifactorial and can be interpreted, in part, as possible alteration in cerebral perfusion and inadequate oxygen delivery to the brain cells. The aim of this study was to evaluate...

  • Cardiopulmonary Bypass Ischemic Hepatitis Reported in Five Patients. Damasceno, Telma A.; Filho, Adilson Scorzoni; Chahud, Fernando; Rodrigues, Alfredo José; Vilella de Andrade Vicente, Walter; Barbosa Evora, Paulo Roberto // Brazilian Journal of Cardiovascular Surgery;July-September 2016, Vol. 31 Issue 4, p330 

    Objective: In cardiac surgery, the lung, renal and neurological events are the most frequent complications. Less common, acute liver failure is a serious complication that adds high morbidity, mortality, and costs. Therefore, this communication aimed to retrospectively evaluate five patients who...

  • Comparison of the effect of 6% hydroxyethyl starch and gelatine on cardiac and stroke volume index: a randomized, controlled trial after cardiac surgery. Schramko, Alexey A.; Suojaranta-Ylinen, Raili T.; Kuitunen, Anne H.; Raivio, Peter M.; Kukkonen, Sinikka I.; Niemi, Tomi T. // Perfusion;Sep2010, Vol. 25 Issue 5, p283 

    Background and aims: The objective of this study was to find out the effect of various doses of hydroxyethyl starch (HES), gelatine or Ringer's acetate on cardiac and stroke volume index after cardiac surgery. Material and methods: Three consecutive boluses (each 7 mL·kg-1) of either 6% HES...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics