Comparison of Albumin, Hydroxyethyl Starch and Ringer Lactate Solution as Priming Fluid for Cardiopulmonary Bypass in Paediatric Cardiac Surgery
Introduction: In paediatric cardiac surgery, there is still not any information with regard to the best choice of priming fluids for Cardiopulmonary Bypass (CPB). Albumin, Hydroxyethyl Starch (HES) & ringer lactate are equally used, but each has its advantages & disadvantages. Albumin &a...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-06-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7918/18465_CE(Ra1)_F(GH)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: In paediatric cardiac surgery, there is still not
any information with regard to the best choice of priming fluids
for Cardiopulmonary Bypass (CPB). Albumin, Hydroxyethyl
Starch (HES) & ringer lactate are equally used, but each has its
advantages & disadvantages. Albumin & HES had better fluid
balance which affect outcome in paediatric cardiac surgery
significantly.
Aim: To compare priming solution containing albumin,
hydroxyethyl starch and ringer lactate during elective openheart surgery in paediatrics aged up to 3 years.
Materials and Methods: All patients were managed by
standardized institution protocol and were randomly distributed
into three groups based on the priming solution which is used in
the CPB Circuit and having 35 patients in each group. Group A:
Receive albumin 10 ml/kg in priming solution, Group B: Receive
Hydroxyethyl starch (HES130/0.4) 6% 20ml/kg in priming
solution, Group C: Receive ringer lactate priming solution.
Primary outcome variable included perioperative haemoglobin,
total protein, colloid osmotic pressure, platelets, fluid balance,
urine output, post-operative blood loss, blood products usage,
renal & liver function, extubation time, ICU stay & outcome.
Results: Patients receiving albumin had higher perioperative
platelet count, total protein level & colloid osmotic pressure,
lesser post-operative blood loss & blood products requirement.
Patients receiving HES had lower level of platelets postoperatively than ringer lactate group but not associated
with increase blood loss. HES did not affect renal function &
haemostasis in this dose. Patients receiving ringer lactate had
positive fluid balance intraoperatively. All three groups have
similar effect on renal & liver function, urine output, time to
extubation, ICU stay & outcome.
Conclusion: We conclude that albumin is expensive but better
prime as maintain haemostasis, colloid oncotic pressure &
reduced blood product requirement. HES will not hamper
haemostasis & renal function in lower dose & better than
crystalloid as maintain negative fluid balance. Patient outcome
& ICU stay was similarly affected by priming solutions. |
|---|---|
| ISSN: | 2249-782X 0973-709X |