Rajaie Cardiovascular Research Center, Iran University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2020 Jan;14(1):36-43.
A vast range of factors cause adverse outcomes after coronary surgery. The goal of this study was to figure out if there was a relation between large volumes of fluid balance in patients who underwent coronary surgery and common complications after CABG.
130 candidates for on-pump CABG were enrolled in our study at Rajaie Cardiovascular Medical and Research Center in 2016. After calculating balance volume for each patient, they were divided into 3 groups; Group (1): fluid balance < 2000 mL, Group (2): fluid balance 2000-3000 mL, Group (3): fluid balance > 3000 mL. Some of the post-surgery complications were studied in these 3 groups. Since in similar studies, fluid overload has been investigated based on the patient's weight gain after surgery or only on the basis of the patient's fluid intake, we designed a study based on an accurate fluid balance measurement, which included the subtraction of the patient's outputs and losses from their intakes.
Logistic Regression showed that fluid balance > 3000ml was the predictor of long mechanical ventilation [ (Odds Ratio (95% CI) = 4.6 (1.9 - 11.5), P < .05], more than 3 days of ICU stay [(Odds Ratio (95% CI) = 3.2 (1.09 - 9.6), P < .05], and longer hospital stay [Odds Ratio (95% CI) = 5.2 (1.9 - 14.08), P < .05]. There was no significant relation between AKI and fluid balance.
Administration of large fluid volumes in CABG patients would lead to fluid accumulation and independently associated with prolonged mechanical ventilation, longer ICU stays and extended hospital stays.
冠状动脉手术后出现不良后果的原因有很多。本研究旨在探讨冠状动脉搭桥术(CABG)患者的液体平衡量与 CABG 后常见并发症之间是否存在关系。
2016 年,我们在 Rajaie 心血管医学和研究中心对 130 名拟行体外循环下 CABG 的患者进行了研究。计算每位患者的平衡量后,将其分为 3 组:组 1:液体平衡量<2000ml;组 2:液体平衡量 2000-3000ml;组 3:液体平衡量>3000ml。研究了这 3 组患者的一些术后并发症。由于在类似的研究中,液体超负荷是基于患者术后体重增加或仅基于患者液体摄入来研究的,因此我们设计了一项基于准确液体平衡测量的研究,其中包括从患者的摄入量中减去患者的输出和损失。
逻辑回归显示,液体平衡量>3000ml 是机械通气时间延长的预测因子[(优势比(95%可信区间)=4.6(1.9-11.5),P<0.05],ICU 入住时间超过 3 天[(优势比(95%可信区间)=3.2(1.09-9.6),P<0.05],以及住院时间延长[(优势比(95%可信区间)=5.2(1.9-14.08),P<0.05]。AKI 与液体平衡量之间无显著关系。
在 CABG 患者中给予大量液体可导致液体蓄积,并与机械通气时间延长、ICU 入住时间延长和住院时间延长独立相关。