The Effect of Gain in Total Body Water on Haemoglobin Concentration and Body Weight Following Cardiac Surgery

Slight, Robert; Demosthenous, Nestor; Nzewi, Onyekwelu; Soliman, Ahmed; McClelland, D. B. L.; Mankad, Pankaj

doi:10.1016/j.hlc.2006.03.013

Cited by 11 publications

(7 citation statements)

References 16 publications

(14 reference statements)

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“…20 Therefore, in the present study tolvaptan was administered for only 5 days postoperatively to avoid the development of extreme dehydration, hypernatremia, and renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery?　― Results of a Single-Center Randomized Controlled Study ―

Kishimoto

Nakamura

Harada

et al. 2018

Circ J

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Background: Oral administration of tolvaptan, a vasopressin V2 receptor antagonist, significantly reduces deterioration of renal function, which has recently been highlighted as an exacerbating factor for adverse events in patients with acute heart failure. In the present study we tested the hypothesis that concomitant administration of tolvaptan with a conventional diuretic is beneficial for perioperative body fluid management in patients who have undergone cardiac surgery. Methods and Results:In all, 280 patients who underwent cardiac surgery were prospectively randomized to concomitant treatment with tolvaptan and a conventional diuretic (tolvaptan group; 147 patients) or treatment with a conventional diuretic alone (control group; 133 patients). Groups were compared in terms of the time required to restore preoperative body weight and the incidence of worsening renal function (WRF), defined as an increase in the serum creatinine level ≥0.3 mg/dL. The time required to restore preoperative body weight was significantly shorter in the tolvaptan than control group (mean [±SD] 3.97±1.95 vs. 5.02±2.83 days, respectively; P<0.001). The incidence of WRF was significantly lower in the tolvaptan than control group (n=11 [7.5%] vs. n=25 [18.8%], respectively; P=0.011). Conclusions:Administration of tolvaptan with conventional diuretics in the early postoperative period after cardiac surgery could be beneficial in maintaining urine output without affecting renal function and may thus help avoid WRF.

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“…20 Therefore, in the present study tolvaptan was administered for only 5 days postoperatively to avoid the development of extreme dehydration, hypernatremia, and renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery?　― Results of a Single-Center Randomized Controlled Study ―

Kishimoto

Nakamura

Harada

et al. 2018

Circ J

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“…Although numerous clinical scales exist to evaluate frailty and predict outcomes, many scales are time‐consuming to administer, motivating the search for objective biomarkers that can serve as specific indicators of frailty. Bioimpedance is a noninvasive method for body composition assessment that has been extensively validated for evaluation of body composition2, 3, 4, 5, 6 and hydration status7, 8, 9, 10, 11, 12, 13 in patients undergoing cardiac surgery. Phase angle (PA) is a measurement obtained via bioimpedance analysis that reflects the resistance and reactance of the human body in response to the application of an external current 14.…”

Section: Introductionmentioning

confidence: 99%

Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Mullie

O’Brand

Bendayan

et al. 2018

JAHA

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BackgroundPhase angle (PA) is a bioimpedance measurement that is determined lean body mass and hydration status. Patients with low PA values are more likely to be frail, sarcopenic, or malnourished. Previous work has shown that low PA predicts adverse outcomes after cardiac surgery, but the effect of PA on survival has not previously been assessed in this setting.Methods and ResultsThe BICS (Bioimpedance in Cardiac Surgery) study recruited 277 patients undergoing major cardiac surgery at 2 university‐affiliated hospitals in Montreal, QC, Canada. Bioimpedance measurements as well as frailty and nutritional assessments were performed preoperatively. The primary outcome was all‐cause mortality. Secondary outcomes were 30‐day mortality, postoperative morbidity, and hospital length of stay. There were 10 deaths at 1 month of follow‐up and 16 deaths at 12 months of follow‐up. PA was associated with age, sex, body mass index, comorbidities, and frailty, as measured by the Short Physical Performance Battery and Fried scales. After adjusting for Society of Thoracic Surgeons–predicted mortality, lower PA was associated with higher mortality at 1 month (adjusted odds ratio, 3.57 per 1° decrease in PA; 95% confidence interval, 1.35–9.47) and at 12 months (adjusted odds ratio, 3.03 per 1° decrease in PA; 95% confidence interval, 1.30–7.09), a higher risk of overall morbidity (adjusted hazard ratio, 2.51 per 1° decrease in PA; 95% confidence interval, 1.32–4.75), and a longer hospital length of stay (adjusted β, 4.8 days per 1° decrease in PA; 95% confidence interval, 1.3–8.2 days).ConclusionsLow PA is associated with frailty and is predictive of mortality, morbidity, and length of stay after major cardiac surgery. Further work is needed to determine the responsiveness of PA to interventions aimed at reversing frailty.

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“…Patients undergoing cardiac surgery invariably receive a large clear fluid load from both the cardiopulmonary bypass (CPB) circuit and the intravenous fluids administered [1,2]. Such haemodilution has a major effect on haemoglobin (Hb) concentration.…”

Section: Introductionmentioning

confidence: 99%

Rationalizing blood transfusion in cardiac surgery: preliminary findings with a red cell volume‐based model

et al. 2006

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The Effect of Gain in Total Body Water on Haemoglobin Concentration and Body Weight Following Cardiac Surgery

Cited by 11 publications

References 16 publications

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery?　― Results of a Single-Center Randomized Controlled Study ―

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery?　― Results of a Single-Center Randomized Controlled Study ―

Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Rationalizing blood transfusion in cardiac surgery: preliminary findings with a red cell volume‐based model

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The Effect of Gain in Total Body Water on Haemoglobin Concentration and Body Weight Following Cardiac Surgery

Cited by 11 publications

References 16 publications

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery? ― Results of a Single-Center Randomized Controlled Study ―

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery? ― Results of a Single-Center Randomized Controlled Study ―

Phase Angle as a Biomarker for Frailty and Postoperative Mortality: The BICS Study

Rationalizing blood transfusion in cardiac surgery: preliminary findings with a red cell volume‐based model

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Product

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Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery?　― Results of a Single-Center Randomized Controlled Study ―

Can Tolvaptan Protect Renal Function in the Early Postoperative Period of Cardiac Surgery?　― Results of a Single-Center Randomized Controlled Study ―