Aukerman J, Voepel-Lewis T, Riegger L Q, Siewert M, Shayevitz J R, Mosca R
Department of Anesthesiology, University of Michigan Health Care Center, Ann Arbor 48109-0211, USA.
J Cardiothorac Vasc Anesth. 1998 Aug;12(4):408-14. doi: 10.1016/s1053-0770(98)90193-8.
This study evaluated postoperative weight gain in children who received albumin versus crystalloid prime for cardiopulmonary bypass (CPB).
A retrospective case-controlled study. Children whose extracorporeal (EC) circuit prime contained albumin (group 1) were matched with those whose prime contained only crystalloid (group 2) on the basis of age, weight, and surgical repair.
A university-based medical center.
Seventy-six children (newborn to 4 years of age) who underwent CPB for correction of a congenital heart anomaly from 1993 to 1995. Group 1 underwent surgery from October 1994 to September 1995, and group 2 from February 1993 to September 1994.
None.
Group 1 had less weight gain on postoperative days (PODs) 1, 2 and 3 compared with group 2 (p = 0.04 on POD 1). Albumin (grams per milliliter) prime and prime volume in milliliters per kilogram were the best predictors of weight gain (p < 0.004), with prime volume being the more important. Children who weighed less than 7.5 kg received more prime volume and had greater weight gain than children who weighed 7.5 kg or greater on PODs 1, 2, and 3 (p < 0.02).
Data suggest that adding albumin to the EC circuit prime and minimizing the prime volume will result in less postoperative weight gain. Further prospective study with a larger sample is warranted to determine whether albumin prime offers other clinical benefits.
本研究评估了接受白蛋白与晶体预充液进行体外循环（CPB）的儿童术后体重增加情况。
一项回顾性病例对照研究。根据年龄、体重和手术修复情况，将体外循环（EC）回路预充液中含有白蛋白的儿童（第1组）与预充液仅含晶体的儿童（第2组）进行匹配。
一家大学附属医院。
1993年至1995年期间接受CPB以纠正先天性心脏异常的76名儿童（新生儿至4岁）。第1组于1994年10月至1995年9月接受手术，第2组于1993年2月至1994年9月接受手术。
无。
与第2组相比，第1组在术后第1、2和3天体重增加较少（术后第1天p = 0.04）。白蛋白（每毫升克数）预充液和每千克毫升数的预充液量是体重增加的最佳预测指标（p < 0.004），其中预充液量更为重要。体重小于7.5 kg的儿童在术后第1、2和3天接受的预充液量更多，体重增加也比体重7.5 kg或更大的儿童更多（p < 0.02）。
数据表明，在EC回路预充液中添加白蛋白并尽量减少预充液量将导致术后体重增加减少。有必要进行进一步的大样本前瞻性研究，以确定白蛋白预充液是否具有其他临床益处。
