High volumes of intravenous fluid during cardiac surgery are associated with increased mortality
Related Experiment Video
Updated: May 13, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
A Pradeep1, S Rajagopalam, H K Kolli
1University at Buffalo (SUNY), Buffalo, NY.
Insights
Excessive intra-operative intravenous fluids in cardiac surgery correlate with higher 90-day mortality. Limiting fluid administration post-surgery may improve patient survival rates and reduce complications.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Critical Care Medicine
Background:
- Positive fluid balance is linked to increased morbidity in abdominal surgery.
- A hypothesis proposed a link between large intravenous fluid volumes during cardiac surgery and increased mortality.
Purpose of the Study:
- To investigate the association between intra-operative intravenous fluid administration and 90-day mortality in cardiac surgery patients.
- To determine if exceeding median fluid volumes impacts patient outcomes.
Main Methods:
- Retrospective analysis of 1358 cardiac surgery patients (2001-2005).
- Patients categorized by fluid volume received (above vs. below median of 3.9 L).
- Acute Kidney Injury (AKI) defined using standard creatinine criteria.
Main Results:
- Increased 90-day mortality observed in patients receiving above-median fluid volumes (HR -2.8).
- Propensity score analysis confirmed this association.
- Survival probability significantly decreased after approximately 4.0 L of intra-operative fluid.
Conclusions:
- Large intra-operative intravenous fluid volumes are independently associated with increased 90-day mortality in cardiac surgery.
- Fluid management strategies may be critical for improving outcomes in these patients.
Introduction:
Positive fluid balance during abdominal surgery has been associated with increased morbidity. We hypothesized that administration of large volumes of intravenous fluids in cardiac surgery is associated with increased mortality.
Methods:
Retrospective analysis of data on 1358 patients who underwent cardiac surgery from 2001 to 2005 at two major hospitals in Western New York. Patients were divided in to those who received intravenous fluids above the median volume (3.9 L) and those who received less than the median volume of intra-operative fluid. Acute Kidney Injury Network criteria based on serum creatinine were used to define Acute Kidney injury.
Results:
Logistic regression and Cox-proportional models showed increased 90 day mortality (HR -2.8, 95% CI -1.16-7.01) in those patients who received greater than the median volume of intravenous during cardiac surgery. This was confirmed with propensity score analysis. Furthermore, the marginal effects analysis revealed that after about 4.0 liters of intravenous fluid, the survival probability falls significantly in cardiac surgery patients.
Conclusions:
Administration of large volumes of intra-operative intravenous fluid is independently associated with an increase in 90 day mortality in cardiac surgery.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:24Hemodialysis II: Procedure and Complications
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:22Heart Failure VI: Adjunct Therapies
01:22Aneurysm IV: Nursing Management
01:26Cardiac Catheterization IV: Nursing Management