Järvelä Kati, Rantanen Markku, Kööbi Tiit, Huhtala Heini, Sisto Tero
Heart Center Co., Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland.
Anaesthesiol Intensive Ther. 2018;50(2):122-127. doi: 10.5603/AIT.2018.0019.
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).
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.
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.
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.
在使用体外循环（CPB）的心脏手术后，显著的液体潴留很常见。本研究的目的是评估高渗盐水-羟乙基淀粉（HS-HES）溶液对接受冠状动脉旁路移植术（CABG）患者液体蓄积的影响。
五十名接受冠状动脉旁路手术的成年男性患者被纳入这项干预性、随机、双盲研究，以比较HS-HES与盐溶液。在主动脉钳夹松开时，将研究液体（250毫升）注入CPB回路的静脉储液器中。
与对照组相比，HS-HES组从基线到术后第一个早晨的体重变化显著更小（3.3±1.5千克对4.4±1.5千克，P = 0.022）。在细胞外液（ECW）或ECW平衡方面，两组之间没有显著差异。围手术期两组对液体和利尿剂药物的需求没有差异。
我们的研究表明，250毫升HS-HES溶液在一定程度上可减少接受CPB的CABG手术患者的围手术期液体蓄积。
