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Fluid distribution kinetics during cardiopulmonary bypass
Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
2014 (English)In: Clinics, ISSN 1807-5932, E-ISSN 1980-5322, Vol. 69, no 8, 535-541 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

The purpose of this study was to examine the isovolumetric distribution kinetics of crystalloid fluid during cardiopulmonary bypass.

METHODS:

Ten patients undergoing coronary artery bypass grafting participated in this prospective observational study. The blood hemoglobin and the serum albumin and sodium concentrations were measured repeatedly during the distribution of priming solution (Ringer's acetate 1470 ml and mannitol 15% 200 ml) and initial cardioplegia. The rate of crystalloid fluid distribution was calculated based on 3-min Hb changes. The preoperative blood volume was extrapolated from the marked hemodilution occurring during the onset of cardiopulmonary bypass. Clinicaltrials.gov: NCT01115166.

RESULTS:

The distribution half-time of Ringer's acetate averaged 8 minutes, corresponding to a transcapillary escape rate of 0.38 ml/kg/min. The intravascular albumin mass increased by 5.4% according to mass balance calculations. The preoperative blood volume, as extrapolated from the drop in hemoglobin concentration by 32% (mean) at the beginning of cardiopulmonary bypass, was 0.6-1.2 L less than that estimated by anthropometric methods (p<0.02). The mass balance of sodium indicated a translocation from the intracellular to the extracellular fluid space in 8 of the 10 patients, with a median volume of 236 ml.

CONCLUSIONS:

The distribution half-time of Ringer's solution during isovolumetric cardiopulmonary bypass was 8 minutes, which is the same as for crystalloid fluid infusions in healthy subjects. The intravascular albumin mass increased. Most patients were hypovolemic prior to the start of anesthesia. Intracellular edema did not occur.

Place, publisher, year, edition, pages
Faculdade de Medicina / USP , 2014. Vol. 69, no 8, 535-541 p.
Keyword [en]
Cardiopulmonary Bypass; Fluid Shifts; Albumin; Blood Volume
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-111307DOI: 10.6061/clinics/2014(08)06ISI: 000341384600006PubMedID: 25141112OAI: oai:DiVA.org:liu-111307DiVA: diva2:755265
Note

Funding Agencies|Ostergotland County Council [61791, 129561]

Available from: 2014-10-14 Created: 2014-10-14 Last updated: 2017-12-05Bibliographically approved

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Hahn, RobertZdolsek, Joachim

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Department of Thoracic and Vascular SurgeryDivision of Drug ResearchFaculty of Health SciencesDepartment of Anaesthesiology and Intensive Care in Linköping
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