Intra- and extravascular volume status in patients undergoing mitral valve replacement

Rex, Steffen; Scholz, Martin; Weyland, A.; Busch, T.; Schorn, B.; Buhre, W.

doi:10.1017/s0265021505001687

Cited by 24 publications

(25 citation statements)

References 35 publications

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“…The purpose of colloid administration is to maintain osmotic pressure and avoid interstitial fluid retention . Rex et al studied adults undergoing mitral valve replacement and found that 4% albumin added to the pump prime volume significantly increased total blood volume and reduced extravascular fluid compared with Ringer's lactate . However, there are concerns regarding renal function following colloid administration.…”

Section: Discussionmentioning

confidence: 99%

The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial

Lee

Kim

et al. 2017

Anaesthesia

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We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared. The incidence of acute kidney injury determined by Paediatric Risk, Injury, Failure, Loss, End-stage renal disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria were no different between the two groups (starch group 40.8% vs. control group 30.0%; p = 0.150 using pRIFLE; 19.6% vs. 21.1% respectively, p = 0.602 using AKIN). There were no differences in clinical outcomes such as mortality, major adverse events, intensive care unit stay or duration of mechanical ventilation. Clotting time as measured using rotational thromboelastometry (ROTEM) was prolonged, and clot firmness after 10 min and maximal clot firmness were shorter in the starch group compared with the control group after sternal closure. There was no difference in transfusion between the two groups. Patients with acute kidney injury had worse clinical courses than those without acute kidney injury. We conclude that intra-operative use of 6% hydroxyethyl starch 130/0.4 up to 30 ml.kg was not associated with postoperative acute kidney injury in paediatric cardiac patients.

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Section: Discussionmentioning

confidence: 99%

The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial

Lee

Kim

et al. 2017

Anaesthesia

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“…These solutions can prevent capillary escape, which leads to fluid escape to tissue intervals, and tissue edema, which is caused by decreased oncotic pressure during CPB. 16,17 Several studies that used albumin and HES as priming solutions indicate that conservation of colloid osmotic pressure during CPB reduced the fluid amount accumulated between the tissues. 18 Also, colloidal priming solution usage reduced the total blood volume and intraoperative fluid requirement.…”

Section: Discussionmentioning

confidence: 99%

“…18 Also, colloidal priming solution usage reduced the total blood volume and intraoperative fluid requirement. 17 Tiryakioglu and colleagues 19 compared the RL and HES 130/0.4 usage as the priming solution on adult patients and observed that BUN and serum creatinine levels were higher in the HES 130/0.4 group at postoperative 24th hour. The research group evaluated the possible negative effects of HES 130/0.4 on renal functions, but serious renal damages or failures were not observed in patients.…”

Section: Discussionmentioning

confidence: 99%

The Effect of HES (130/0.4) Usage as the Priming Solution on Renal Function in Children Undergoing Cardiac Surgery

et al. 2012

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Background: Experience with hydroxyethyl starch (HES) in children is limited. This study was conducted to observe the effects of HES or Ringer's lactate (RL) usage as the priming solution on renal functions in children undergoing cardiac surgery. Methods: After ethical committee approval and parent informed consent, 24 patients were included in this prospective, randomized study. During cardiopulmonary bypass (CPB), Group I received RL and Group II received HES (130/0.4) as priming solution. Serum creatinine, blood urea nitrogen (BUN), β2-microglobulin, cystatin C, and urinary albumin and creatinine, serum, and urine electrolytes were analyzed after the induction (T1), before CPB (T2), during CPB (T3), after CPB (T4), at the end of the operation (T5), on 24th hour (T6), and on 48th hour postoperatively (T7). Fractional sodium excretion (FENa), urinary albumin/creatinine ratio, and creatinine clearance were calculated. Drainage, urine output, inotropes, diuretics, and blood requirements were recorded. Results: In both the groups, β2-microglobulin was decreased during CPB and cystatin C was decreased at T3,T4, and T5 periods (p < 0.05) and the levels remained within the normal range. Creatinine clearance did not differ in the HES group, but increased in the RL group (p < 0.05). Urine albumin/creatinine ratio was increased (p < 0.05) after CPB in the HES group, and it increased at T3, T4, and T5 in the RL group (p < 0.05). There were no differences in cystatin C, β2-microglobulin, FENa, urine albumin/creatinine ratio, creatinine clearance, total fluid amount, urine output, drainage, and inotropic and diuretic requirements between the groups. Conclusion: We conclude that usage of HES (130/0.4) did not have negative effects on renal function, and it can be used as a priming solution in pediatric patients undergoing cardiac surgery.

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“…28 Total blood volume and extravascular accumulation of fluid take at least 24 h to normalise when using colloidal priming solution, and even longer when crystalloid solution is used. 29,30 Onotic pressure remains low for 24 h post-surgery when using crystalloids, a factor that could contribute to continued accumulation of extravascular fluid and morbidity. 30 Although we did not record complications in our study, the longer length of ICU stay in the control group could be linked to a positive fluid balance and its effect on organs such as the lungs, kidneys and heart.…”

Section: Discussionmentioning

confidence: 99%

Effect of priming solution and ultrafiltration on post-operative bleeding and blood transfusion in cardiac surgery. Randomized controlled trial

Rodríguez

Hernández

Bárcenas

et al. 2015

Revista Española de Anestesiología y Reanimación (English Editi

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Intra- and extravascular volume status in patients undergoing mitral valve replacement

Abstract: The use of colloid priming solutions in patients with mitral valve insufficiency leads to less fluid requirements and significantly reduced fluid shift in the interstitium. However, these changes are not associated with changes in haemodynamic parameters or short term outcome.

Cited by 24 publications

References 35 publications

The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial

The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial

The Effect of HES (130/0.4) Usage as the Priming Solution on Renal Function in Children Undergoing Cardiac Surgery

Effect of priming solution and ultrafiltration on post-operative bleeding and blood transfusion in cardiac surgery. Randomized controlled trial

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