Published in:
01-10-2008 | Original
Half-molar sodium-lactate solution has a beneficial effect in patients after coronary artery bypass grafting
Published in: Intensive Care Medicine | Issue 10/2008
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Objective
To compare two solutions for fluid resuscitation in post-coronary artery bypass grafting (CABG) surgery patients: Ringer’s lactate (RL) versus a new solution containing half-molar sodium-lactate (HL).
Design
Prospective randomized open label study.
Setting
The first 12 h post-CABG surgery in an intensive care unit (ICU).
Patients
There were 230 patients enrolled in the study: 208 were analyzed, with 109 from the HL group and 99 from the RL group.
Interventions
Patients received over the first 12 h post-CABG 10 ml kg BW−1 HL solution in the HL group versus 30 ml kg BW−1 of RL solution in the RL group.
Measurements and results
Hemodynamic status, body fluid balance and inotrope utilization were compared in the two groups. Post-operative cardiac index increase was significantly higher in HL than in RL (P = 0.02), while mean arterial pressure and other hemodynamic parameters were comparable together with urinary output, indicating similar tissue perfusion in both the groups despite a much lower fluid infusion in the HL group. Therefore, a significant negative fluid balance was achieved in the HL but not in the RL group (−790 ± 71 vs. +43 ± 115 mL 12 h−1, P < 0.0001 for HL and RL, respectively). None of the enrolled patients exhibited side effects related to the treatment.
Conclusion
Half-molar lactate solution is effective for fluid resuscitation in post-CABG patients. Compared to Ringer’s Lactate, its use results in a significantly higher cardiac index with less volume being infused, resulting in a very negative post-operative body fluid balance.