Cutuli, Salvatore L; Bitker, Laurent; Osawa, Eduardo A; O'Brien, Zachary; Canet, Emmanuel; Yanase, Fumitaka; Ancona, Paolo; Wilson, Anthony; Lucchetta, Luca; Kubicki, Mark; Cronhjort, Maria; Cioccari, Luca; Peck, Lea; Young, Helen; Eastwood, Glenn M; Mårtensson, Johan; Glassford, Neil J; Bellomo, Rinaldo (2020). Haemodynamic effect of a 20% albumin fluid bolus in post-cardiac surgery patients. Critical care and resuscitation, 22(1), pp. 15-25. College of Intensive Care Medicine of Australia and New Zealand
Full text not available from this repository. (Request a copy)OBJECTIVE
To study the cardiovascular effect over 30 minutes following the end of fluid bolus therapy (FBT) with 20% albumin in patients after cardiac surgery.
DESIGN
Prospective observational study.
SETTING
Intensive care unit of a tertiary university-affiliated hospital.
PARTICIPANTS
Twenty post-cardiac surgery mechanically ventilated patients with a clinical decision to administer FBT.
INTERVENTION
FBT with a 100 mL bolus of 20% albumin.
MAIN OUTCOME MEASURES
Cardiac index (CI) response was defined by a ≥ 15% increase, while mean arterial pressure (MAP) response was defined by a ≥ 10% increase.
RESULTS
The most common indication for FBT was hypotension (40%). Median duration of infusion was 7 minutes (interquartile range [IQR], 3-9 min). At the end of FBT, five patients (25%) showed a CI response, which increased to almost half in the following 30 minutes and dissipated in one patient. MAP response occurred in 11 patients (55%) and dissipated in five patients (45%) by a median of 6 minutes (IQR, 6-10 min). CI and MAP responses coexisted in four patients (20%). An intrabolus MAP response occurred in 17 patients (85%) but dissipated in 11 patients (65%) within a median of 7 minutes (IQR, 2-11 min). On regression analysis, faster fluid bolus administration predicted MAP increase at the end of the bolus.
CONCLUSION
In post-cardiac surgery patients, CI response to 20% albumin FBT was not congruous with MAP response over 30 minutes. Although hypotension was the main indication for FBT and a MAP response occurred in most of patients, such response was maximal during the bolus, dissipated in a few minutes, and was dissociated from the CI response.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care |
UniBE Contributor: |
Cioccari, Luca (A) |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1441-2772 |
Publisher: |
College of Intensive Care Medicine of Australia and New Zealand |
Language: |
English |
Submitter: |
Isabelle Arni |
Date Deposited: |
19 Jun 2020 14:29 |
Last Modified: |
29 Mar 2023 23:37 |
PubMed ID: |
32102639 |
URI: |
https://boris.unibe.ch/id/eprint/144766 |
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