Hypertonic saline-hydroxyethyl starch solution attenuates fluid accumulation in cardiac surgery patients: a randomized controlled double-blind trial

Anaesthesiol Intensive Ther. 2018;50(2):122-127. doi: 10.5603/AIT.2018.0019.

Abstract

Background: Significant fluid retention is common after cardiac surgery with the use of cardiopulmonary bypass (CPB). The aim of the study was to evaluate the effects of hypertonic saline-hydroxyethyl starch (HS-HES) solution on fluid accumulation in patients undergoing coronary artery bypass grafting surgery (CABG).

Methods: Fifty adult male patients undergoing coronary bypass surgery were enrolled in this interventional, randomized, double-blinded study to compare HS-HES with saline solution. The study fluid (250 mL) was given into the venous reservoir of the CPB circuit at the time of aortic declamping.

Results: Body mass change from the baseline to the first postoperative morning was significantly less in the HS-HES group compared with the control group (3.3 ± 1.5 kg vs. 4.4 ± 1.5 kg, P = 0.022). In the extracellular water (ECW) or ECW-balance, there were no significant differences between the groups. The need for fluids and diuretic medication did not differ between the groups during the perioperative period.

Conclusions: Our study shows that 250 mL of HS-HES solution can reduce perioperative fluid accumulation to some degree in patients undergoing CABG surgery with CPB.

Keywords: cardiopulmonary bypass; coronary artery bypass; hypertonic; saline solution; water.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Water / metabolism
  • Body Weight
  • Cardiac Surgical Procedures / methods*
  • Coronary Artery Bypass
  • Diuretics / therapeutic use
  • Double-Blind Method
  • Extracellular Space / metabolism
  • Fluid Therapy / methods*
  • Humans
  • Hydroxyethyl Starch Derivatives / therapeutic use*
  • Male
  • Middle Aged
  • Saline Solution, Hypertonic / therapeutic use*
  • Treatment Outcome
  • Water-Electrolyte Balance / drug effects*

Substances

  • Diuretics
  • Hydroxyethyl Starch Derivatives
  • Saline Solution, Hypertonic