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.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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