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

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.