Colloids in Cardiac Surgery—Friend or Foe?

Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery

“…21 Postoperative acute kidney injury was defined as newly initiated renal replacement therapy on the ICU. 22 Myocardial infarction was defined as creatine kinase MB isoenzyme mass of >70 mg ml À1 on the operation day, or >100 mg ml À1 on the 1st postoperative morning. 23,24 Prolonged ICU stay was defined as more than 2.1 days (90th percentile), similar to in earlier studies.…”

Association between albumin administration and survival in cardiac surgery: a retrospective cohort study

“…The results of this study are different from those of a recent observational study within a cardiac surgical population in which a greater risk of postoperative dialysis was associated with albumin compared with crystalloid utilization. 23 Nevertheless, the albumin group included patients who received volumes of 20% and/or 5% albumin, and the type received by each patient was not known with certainty, while the current study restricted analysis to patients who received solely 5% albumin. While Ryhammer et al 23 found that patients administered 20% albumin had nearly a three-fold increased risk of postoperative dialysis compared with those thought to receive 5% albumin, there was no propensity-matched analysis of patients who received crystalloids vs 5% albumin performed, making it difficult to draw conclusions.…”

“…23 Nevertheless, the albumin group included patients who received volumes of 20% and/or 5% albumin, and the type received by each patient was not known with certainty, while the current study restricted analysis to patients who received solely 5% albumin. While Ryhammer et al 23 found that patients administered 20% albumin had nearly a three-fold increased risk of postoperative dialysis compared with those thought to receive 5% albumin, there was no propensity-matched analysis of patients who received crystalloids vs 5% albumin performed, making it difficult to draw conclusions. 23 Procedure-to-discharge length of stay and all-cause 30day readmission rate post cardiac surgery represent surrogates of cost.…”

“…While Ryhammer et al 23 found that patients administered 20% albumin had nearly a three-fold increased risk of postoperative dialysis compared with those thought to receive 5% albumin, there was no propensity-matched analysis of patients who received crystalloids vs 5% albumin performed, making it difficult to draw conclusions. 23 Procedure-to-discharge length of stay and all-cause 30day readmission rate post cardiac surgery represent surrogates of cost. No difference between lengths of stay (ESM Table 6) suggests possible comparable treatment costs between patients treated with albumin and crystalloid and those treated with crystalloid alone.…”

“…It was hypothesized that use of a 5% albumin solution is associated with improved outcomes in adult patients undergoing on-pump cardiac surgery compared with patients who received crystalloid alone. Since effects of albumin can depend on the albumin concentration utilized (e.g., 5% vs 20%) and state of inflammation, 23 we limited our investigation to the effects of 5% albumin in on-pump cardiac surgery.…”