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Effects of colloid or crystalloid administration on pulmonary extravascular water in the postoperative period after coronary artery bypass grafting.
Anesth Analg. 1985 Aug; 64(8):753-8.A&A

Abstract

The effect of postoperative fluid management on pulmonary extravascular thermal volume (ETVL) as in index of pulmonary extravascular water after coronary artery bypass grafting was compared, using the thermal-dye technique, among five patients who received 5% albumin (group A), five patients who received 6% hydroxyethyl starch (group H), and five who received lactated Ringer's solution (group C). Intraoperatively, all patients received lactated Ringer's solution intravenously, and the cardiopulmonary bypass (CPB) circuit prime included 5% albumin. No statistically significant changes in ETVL occurred postoperatively in any group, nor did ETVL differ significantly between groups. After CPB, colloid osmotic pressure (COP) significantly decreased and pulmonary artery wedge pressure (WP) and the WP-COP gradient significantly increased in each group, implying an increase in transcapillary fluid flux. Cardiac index changed variably. Pulmonary shunt fraction (Qsp/Qt) did not change in groups A and C but decreased during CPB in group H (from 0.22 +/- 0.03 to 0.16 +/- 0.11). Postoperatively, patients in the three groups received similar volumes of fluids and had similar perioperative weight gains. By the next morning (AM1), COP increased in all groups, returning to levels noted before CPB in group C, and exceeding these levels in groups A and H. Wedge pressure was similar in all three groups on AM1. PaO2 decreased significantly, and alveolar-arterial oxygen partial pressure difference increased significantly in all groups on AM1. In Group H, Qsp/Qt returned to levels observed before CPB by AM1 (0.27 +/- 0.09). We conclude that in patients without postoperative increases in WP, ETVL changes minimally during CPB and is not influenced by the type of fluid administered as the primary volume replacement in the postoperative period.

Authors

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Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2409845

Citation

Gallagher, J D., et al. "Effects of Colloid or Crystalloid Administration On Pulmonary Extravascular Water in the Postoperative Period After Coronary Artery Bypass Grafting." Anesthesia and Analgesia, vol. 64, no. 8, 1985, pp. 753-8.
Gallagher JD, Moore RA, Kerns D, et al. Effects of colloid or crystalloid administration on pulmonary extravascular water in the postoperative period after coronary artery bypass grafting. Anesth Analg. 1985;64(8):753-8.
Gallagher, J. D., Moore, R. A., Kerns, D., Jose, A. B., Botros, S. B., Flicker, S., Naidech, H., & Clark, D. L. (1985). Effects of colloid or crystalloid administration on pulmonary extravascular water in the postoperative period after coronary artery bypass grafting. Anesthesia and Analgesia, 64(8), 753-8.
Gallagher JD, et al. Effects of Colloid or Crystalloid Administration On Pulmonary Extravascular Water in the Postoperative Period After Coronary Artery Bypass Grafting. Anesth Analg. 1985;64(8):753-8. PubMed PMID: 2409845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of colloid or crystalloid administration on pulmonary extravascular water in the postoperative period after coronary artery bypass grafting. AU - Gallagher,J D, AU - Moore,R A, AU - Kerns,D, AU - Jose,A B, AU - Botros,S B, AU - Flicker,S, AU - Naidech,H, AU - Clark,D L, PY - 1985/8/1/pubmed PY - 1985/8/1/medline PY - 1985/8/1/entrez SP - 753 EP - 8 JF - Anesthesia and analgesia JO - Anesth Analg VL - 64 IS - 8 N2 - The effect of postoperative fluid management on pulmonary extravascular thermal volume (ETVL) as in index of pulmonary extravascular water after coronary artery bypass grafting was compared, using the thermal-dye technique, among five patients who received 5% albumin (group A), five patients who received 6% hydroxyethyl starch (group H), and five who received lactated Ringer's solution (group C). Intraoperatively, all patients received lactated Ringer's solution intravenously, and the cardiopulmonary bypass (CPB) circuit prime included 5% albumin. No statistically significant changes in ETVL occurred postoperatively in any group, nor did ETVL differ significantly between groups. After CPB, colloid osmotic pressure (COP) significantly decreased and pulmonary artery wedge pressure (WP) and the WP-COP gradient significantly increased in each group, implying an increase in transcapillary fluid flux. Cardiac index changed variably. Pulmonary shunt fraction (Qsp/Qt) did not change in groups A and C but decreased during CPB in group H (from 0.22 +/- 0.03 to 0.16 +/- 0.11). Postoperatively, patients in the three groups received similar volumes of fluids and had similar perioperative weight gains. By the next morning (AM1), COP increased in all groups, returning to levels noted before CPB in group C, and exceeding these levels in groups A and H. Wedge pressure was similar in all three groups on AM1. PaO2 decreased significantly, and alveolar-arterial oxygen partial pressure difference increased significantly in all groups on AM1. In Group H, Qsp/Qt returned to levels observed before CPB by AM1 (0.27 +/- 0.09). We conclude that in patients without postoperative increases in WP, ETVL changes minimally during CPB and is not influenced by the type of fluid administered as the primary volume replacement in the postoperative period. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/2409845/Effects_of_colloid_or_crystalloid_administration_on_pulmonary_extravascular_water_in_the_postoperative_period_after_coronary_artery_bypass_grafting_ L2 - https://Insights.ovid.com/pubmed?pmid=2409845 DB - PRIME DP - Unbound Medicine ER -