The hemodynamic effects of warm versus room-temperature crystalloid fluid bolus therapy in post-cardiac surgery patients.

Bitker, Laurent; Cutuli, Salvatore L; Yanase, Fumitaka; Wilson, Anthony; Osawa, Eduardo A; Lucchetta, Luca; Cioccari, Luca; Canet, Emmanuel; Glassford, Neil; Eastwood, Glenn M; Bellomo, Rinaldo (2022). The hemodynamic effects of warm versus room-temperature crystalloid fluid bolus therapy in post-cardiac surgery patients. Perfusion, 37(6), pp. 613-623. Sage 10.1177/02676591211012204

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INTRODUCTION

The contribution of fluid temperature to the effect of crystalloid fluid bolus therapy (FBT) in post-cardiac surgery patients is unknown. We evaluated the hemodynamic effects of FBT with fluid warmed to 40°C (warm FBT) versus room-temperature fluid.

METHODS

In this single centre prospective before-and-after study, we evaluated the effects of 500 ml of warm versus room-temperature compound sodium lactate administered over <30 minutes, in 50 cardiac surgery patients admitted to ICU. We recorded hemodynamics continuous before and for 30 minutes after the first FBT. We defined CI responsiveness (CI-R) as an CI increase >15% of baseline immediately after FBT and effect dissipation if the CI returned to <5% of baseline and MAP responsiveness as >10% increase and dissipation as return to <3 mmHg of baseline.

RESULTS

Hypotension (56%) and low CI (40%) typically triggered FBT. Temperature decreased >0.3°C in 13 (52%) patients after room-temperature FBT versus 0 (0%) after warm FBT (p < 0.01). CI and MAP responsiveness was similar (16 [64%] versus 11 [44%], p = 0.15 and 15 [60%] versus 17 [68%], p = 0.77, respectively). Among CI responders, CI increased more with room-temperature FBT (+0.6 [IQR, 0.5-1.1] versus +0.5 [IQR, 0.4-0.6] L/min/m2, p = 0.01). However, dissipation was more common after room-temperature versus warm FBT (9/16 [56%] versus 1/11 [9%], p = 0.02).

CONCLUSION

In postoperative cardiac surgery patients, warm FBT preserved core temperature and induced smaller but more sustained CI increases among responders. Fluid temperature appears to impact both core temperature and the duration of 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:

0267-6591

Publisher:

Sage

Language:

English

Submitter:

Isabelle Arni

Date Deposited:

08 Jun 2021 11:16

Last Modified:

29 Mar 2023 23:37

Publisher DOI:

10.1177/02676591211012204

PubMed ID:

33960224

Uncontrolled Keywords:

cardiac output cardiac surgery fluid bolus therapy physiology temperature control

BORIS DOI:

10.48350/156523

URI:

https://boris.unibe.ch/id/eprint/156523

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