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  1. Home
  3. Twenty Percent Human Albumin Solution Fluid Bolus Administration Therapy In Patients After Cardiac Surgery-ii: A Multicentre Randomised Controlled Trial.
  1. Home
  3. Twenty Percent Human Albumin Solution Fluid Bolus Administration Therapy In Patients After Cardiac Surgery-ii: A Multicentre Randomised Controlled Trial.

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Twenty percent human albumin solution fluid bolus administration therapy in patients after cardiac surgery-II: a

Geoffrey J Wigmore1,2, Adam M Deane3,4, Jeffrey J Presneill3,4,5

  • 1Department of Critical Care, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia. geoff.wigmore@unimelb.edu.au.

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Keywords:
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Fluid bolus therapy with 20% albumin after cardiac surgery reduced fluid balance but did not significantly decrease vasopressor duration compared to crystalloids. This study investigated fluid bolus therapy (FBT) effectiveness.

Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Nephrology

Background:

  • Fluid overload is a common complication after cardiac surgery.
  • Fluid bolus therapy (FBT) is frequently used to manage hemodynamics.
  • The optimal fluid type for FBT in post-cardiac surgery patients remains debated.

Purpose of the Study:

  • To compare the efficacy of 20% human albumin versus crystalloids for fluid bolus therapy in cardiac surgery patients.
  • To determine if 20% albumin FBT reduces the duration of vasopressor therapy compared to crystalloid FBT.
  • To assess the impact of FBT type on fluid balance post-cardiac surgery.

Main Methods:

  • A multicentre, parallel-group, open-label, randomised clinical trial.
  • 240 cardiac surgery patients requiring FBT were randomized to receive either 20% albumin or crystalloid FBT.
  • Primary outcome: cumulative duration of vasopressor therapy; Secondary outcome: fluid balance.

    • Main Results:

    • The median duration of vasopressor therapy was 7 hours with 20% albumin vs. 10.8 hours with crystalloids (P=0.08).
    • A significant reduction in day one fluid balance was observed with 20% albumin FBT (mean difference -701 mL).
    • No statistically significant difference in vasopressor duration was found between the groups.

    Conclusions:

    • In post-cardiac surgery patients, 20% albumin FBT led to a reduced positive fluid balance compared to crystalloid FBT.
    • 20% albumin FBT did not significantly reduce the duration of vasopressor therapy.
    • Albumin-based FBT may be considered for fluid management in specific post-cardiac surgery scenarios.