Fluid therapy using a balanced crystalloid solution and acid-base stability after cardiac surgery.

Area of Science:

• Critical Care Medicine
• Anesthesiology
• Cardiovascular Surgery

Background:

• Post-cardiac surgery patients often experience acid-base disturbances.
• Fluid therapy choices significantly impact acid-base balance.
• Accusol is a crystalloid solution with a high strong ion difference (SID) due to its bicarbonate content.

Purpose of the Study:

• To assess the impact of Accusol fluid therapy on acid-base stability in patients undergoing cardiac surgery.
• To compare the change in standard base excess (SBE) between patients receiving Accusol and those receiving conventional fluids.

Main Methods:

• Retrospective per-protocol comparison of adult patients after elective on-pump coronary artery bypass graft surgery.
• Two groups were analyzed: a pre-Accusol group (n=40) and an Accusol group (n=51).
• Change in SBE was measured from intensive care unit admission to the following morning.

Main Results:

• The Accusol group demonstrated significantly more stable SBE (+0.03 mmol/L) compared to the pre-Accusol group (-2.05 mmol/L).
• The strong ion difference of administered fluids was higher in the Accusol group.
• Fewer patients in the Accusol group received albumin compared to the pre-Accusol group (8% vs. 48%).

Conclusions:

• Accusol fluid administration was associated with improved acid-base stability, indicated by more stable SBE post-cardiac surgery.
• Further research is warranted to investigate the clinical outcomes associated with Accusol use.