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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.
Afiliação
  • Bitker L; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Cutuli SL; Service de Médecine Intensive - Réanimation, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
  • Yanase F; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Wilson A; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Osawa EA; Università Cattolica del Sacro Cuore, Facoltà di Medicina e Chirurgia "A. Gemelli", Rome, Italy.
  • Lucchetta L; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Cioccari L; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Canet E; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Glassford N; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Eastwood GM; Department of Intensive Care, Austin hospital, Melbourne, Australia.
  • Bellomo R; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Melbourne, Australia.
Perfusion ; 37(6): 613-623, 2022 09.
Article em En | MEDLINE | ID: mdl-33960224
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Cardíacos / Hemodinâmica Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Cardíacos / Hemodinâmica Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article