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Fluid distribution kinetics during cardiopulmonary bypass.

Törnudd M, Hahn RG, Zdolsek JH - Clinics (Sao Paulo) (2014)

Bottom Line: 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.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.

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Affiliation: Departments of Cardiovascular and Thoracic Anesthesia, Faculty of Health Sciences, Linköping University, Linköping, Sweden.

ABSTRACT

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.

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Distribution of fluid after one patient was connected to the extracorporeal circuit.
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f2-cln_69p535: Distribution of fluid after one patient was connected to the extracorporeal circuit.

Mentions: The Hb concentration dropped 32% (SD 5) when patients were connected to the ECC. The rate of restoration of the Hb level from its lowest value to a steady state corresponded to a median distribution half-time of 8.0 min (Figure 2).


Fluid distribution kinetics during cardiopulmonary bypass.

Törnudd M, Hahn RG, Zdolsek JH - Clinics (Sao Paulo) (2014)

Distribution of fluid after one patient was connected to the extracorporeal circuit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129556&req=5

f2-cln_69p535: Distribution of fluid after one patient was connected to the extracorporeal circuit.
Mentions: The Hb concentration dropped 32% (SD 5) when patients were connected to the ECC. The rate of restoration of the Hb level from its lowest value to a steady state corresponded to a median distribution half-time of 8.0 min (Figure 2).

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Departments of Cardiovascular and Thoracic Anesthesia, Faculty of Health Sciences, Linköping University, Linköping, Sweden.

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus