Highly positive intraoperative fluid balance during cardiac surgery is associated with adverse outcome

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dc.authorid0000-0002-6376-5735en_US
dc.contributor.authorToraman, F
dc.contributor.authorEvrenkaya, S
dc.contributor.authorYuce, M
dc.contributor.authorTurek, O
dc.contributor.authorAksoy, N
dc.contributor.authorKarabulut, H
dc.contributor.authorDemirhisar, O
dc.contributor.authorAlhan, C
dc.date.accessioned2024-07-12T21:52:46Z
dc.date.available2024-07-12T21:52:46Z
dc.date.issued2004en_US
dc.departmentMaltepe Üniversitesien_US
dc.descriptionWorkshop on Therapeutic Filtration and Extracorporeal Circulation -- 38177 -- Hammersmith Hosp, London, ENGLANDen_US
dc.description.abstractHemodilution and increase in capillary permeability occurring with cardiopulmonary bypass (CPB) impose a risk for tissue edema and blood transfusion that may result in an increased complication rate after coronary artery bypass grafting (CABG). Of the 1280 consecutive patients undergoing isolated on-pump CABG, total fluid balance at the end of the operation was less than or equal to 500 mL in 1155 ( Group 1) and more than 500 mL in 125 ( Group 2). During CPB, blood was added to the reservoir only when the hematocrit fell to 17% or less and crystalloid solution only when the pump flow index fell below 2.0 L/min/m(2). Anesthetic, surgical, and postoperative management and diagnoses were the same in all patients, and a single surgical and anesthesia team performed all operations. No patient was excluded from the study. Results: Hypertension, diabetes, chronic obstructive pulmonary disease, New York Heart Association (NYHA) Class III-/IV, use of angiotensin converting enzyme ( ACE) inhibitors, chronic renal failure, and female gender were the significant preoperative risk factors for increased volume replacement during CPB. The groups were similar in body mass index, preoperative hematocrit values, total fluid balance in the intensive care unit (ICU), and total chest tube output. However, red blood cells' transfusion rate, readmission rate to the ICU and length of hospital stay were significantly higher in Group 2 patients. Multiple logistic regression revealed that age > 70 years (p < 0.001, Odds Ratio (OR): 2, 95% CI: 1.4-2.8), and total fluid balance > 500 mL at the end of the operation (p < 0.01, OR: 2.2, 95% CI: 1.5-3.2) were the predictors of increased length of stay. For transfusion of red blood cells, age > years (p < 0.0001, OR: 2.3, 95% CI: 1.6-3.3), and total fluid balance > 500 mL at the end of the operation (p < 0.001, OR: 2, 95% CI: 1.3-2.9) were the only significant risk factors. This study suggests that intraoperative volume overload increases blood transfusion and length of hospital stay in patients undergoing CABG.en_US
dc.identifier.doi10.1191/0267659104pf723oa
dc.identifier.endpage91en_US
dc.identifier.issn0267-6591
dc.identifier.issue2en_US
dc.identifier.pmid15162922en_US
dc.identifier.scopus2-s2.0-2442500749en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage85en_US
dc.identifier.urihttps://dx.doi.org/10.1191/0267659104pf723oa
dc.identifier.urihttps://hdl.handle.net/20.500.12415/8429
dc.identifier.volume19en_US
dc.identifier.wosWOS:000221462200002en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSAGE PUBLICATIONS LTDen_US
dc.relation.ispartofPERFUSION-UKen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKY03223
dc.titleHighly positive intraoperative fluid balance during cardiac surgery is associated with adverse outcomeen_US
dc.typeArticle
dspace.entity.typePublication

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