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Hypertonic saline-hydroxyethyl starch solution attenuates fluid accumulation in cardiac surgery patients: a

Kati Järvelä1, Markku Rantanen, Tiit Kööbi

  • 1Heart Center Co., Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland. kati.jarvela@sydansairaala.fi.

Anaesthesiology Intensive Therapy
|June 29, 2018
PubMed

Insights

Hypertonic saline-hydroxyethyl starch (HS-HES) solution reduced fluid retention after coronary artery bypass grafting (CABG) surgery. This intervention showed a modest benefit in managing fluid balance in patients undergoing cardiopulmonary bypass (CPB).

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Fluid retention is a frequent complication following cardiac surgery utilizing cardiopulmonary bypass (CPB).
  • Effective management of perioperative fluid balance is crucial for patient outcomes in CABG procedures.

Purpose of the Study:

  • To assess the efficacy of hypertonic saline-hydroxyethyl starch (HS-HES) solution in mitigating fluid accumulation.
  • To evaluate the impact of HS-HES on fluid balance in patients undergoing coronary artery bypass grafting (CABG) surgery.

Main Methods:

  • A randomized, double-blinded, interventional study involving 50 male patients undergoing CABG.
  • Administration of 250 mL of HS-HES solution versus saline solution into the venous reservoir of the CPB circuit.

Main Results:

  • The HS-HES group exhibited significantly less body mass change (3.3 ± 1.5 kg) compared to the control group (4.4 ± 1.5 kg) postoperatively (P = 0.022).
  • No significant differences were observed between groups regarding extracellular water (ECW) or ECW-balance.
  • Perioperative fluid administration and diuretic requirements were comparable between the HS-HES and control groups.

Conclusions:

  • A 250 mL dose of HS-HES solution demonstrated a capacity to reduce perioperative fluid accumulation in CABG patients undergoing CPB.
  • HS-HES may offer a degree of benefit in fluid management strategies for specific cardiac surgical populations.
Abstract

Keywords:
cardiopulmonary bypasscoronary artery bypasshypertonicsaline solutionwater

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