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Hypertonic Solution Decreases Extravascular Lung Water in Cardiac Patients Undergoing Cardiopulmonary Bypass Surgery
Journal of Cardiothoracic and Vascular Anesthesia, 07/31/2012
Clinical Article
Lomivorotov VV et al. – The infusion of hydroxyethyl starch (HSH) leads to significant decreases in the extravascular lung water index during and after cardiac surgery and is associated with better preservation of pulmonary function and transient increases in the cardiac index.
Methods- Twenty–six patients with coronary artery disease who underwent surgery with cardiopulmonary bypass (CPB).
- Patients were allocated randomly to receive 4mL/kg of 7.2% NaCl/hydroxyethyl starch, 200/0.5 (HSH group) or an equal volume of 0.9% NaCl (control group) for 30minutes starting after anesthesia induction.
- The extravascular lung water index, hemodynamic and biochemical data, and the rate of complications were analyzed.
- The extravascular lung water index was significantly lower (7 v 9.5mL/kg) in the HSH group at the first postoperative day (p<0.01).
- The index of arterial oxygenation efficiency was significantly higher at 5minutes and 2 and 4hours after cardiopulmonary bypass (CPB) in the HSH group (p<0.05).
- The alveolar–arterial oxygen tension difference was significantly lower at 5minutes and 2 and 4hours after CPB in the HSH group (p<0.01).
- The cardiac index was significantly higher at 5minutes after infusion in the HSH group (p<0.05).