Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2022; 19 (2): 97-192 ➤ Инфузионные растворы, применяемые при операциях аортокоронарного шунтирования

Infusion solutions used in CABG operations

Authors: Khinchagov D.Ya., Rybka M.M.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-2-119-126

UDC: 616.12-005.4-036.12-089.86:615.355

Link: Clinical Physiology of Blood Circulaiton. 2022; 2 (19): 119-126

Quote as: Khinchagov D.Ya., Rybka M.M. Infusion solutions used in CABG operations. Clinical Physiology of Circulation. 2022; 19 (2): 119–26 (in Russ.). DOI: 10.24022/1814-6910-2022-19-2-119-126

Keywords:  coronary artery bypass surgery infusion solutions postoperative complications

Received / Accepted:  30.07.2021 / 28.02.2022

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Abstract

Infusion therapy is one of the most important components of the anesthetic management of coronary artery bypass surgery. Adequate compensation of intravascular volume is a crucial factor affecting the results of surgical interventions. In this case, not only the volume of the infusion, but also the composition of the infusion solutions is essential. Currently, for infusion therapy, balanced crystalloid solutions or a combination of balanced crystalloid solutions with gelatin or albumin are used. The choice of solutions used for infusion therapy may affect the frequency of postoperative complications.

This article provides information about the main infusion solutions currently used in coronary artery bypass surgery. Their advantages and disadvantages, their impact on hemodynamics, the hemostatic system, the amount of blood loss, the need for blood transfusion and, ultimately, on the results of treatment are analyzed.

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****
  1. Miller T.E., Myles P.S. Perioperative fluid therapy for major surgery. Anesthesiology. 2019; 130: 825–32. DOI: 10.1097/ALN.0000000000002603
  2. Cherniy V.I. The role and place of albumin in modern infusion-transfusion therapy. Emergency Medicine. 2017; 1 (80): 23–31 (in Russ.). DOI: 10.22141/2224-0586.1. 80.2017.94448
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  4. Feldheiser A., Pavlova V., Bonomo T., Jones A., Fotopoulou C., Sehouli Jet al. Balanced crystalloid compared with balanced colloid solution using a goal-directed haemodynamic algorithm. Br. J. Anaesth. 2013; 110 (2): 231–40. DOI: 10.1093/bja/aes377
  5. Lobo D.N., Stanga Z., Aloysius M.M., Wicks C., Nunes Q.M., Ingram K.L. et al. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers. Crit. Care Med. 2010; 38 (2): 464–70. DOI: 10.1097/CCM.0b013e3181bc80f1
  6. Yates D.R., Davies S.J., Milner H.E., Wilson R.J. Crystalloid or colloid for goal-directed fluid therapy in colorectal surgery. Br. J. Anaesth. 2014; 112 (2): 281–9. DOI: 10.1093/bja/aet307
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  8. Mitra S., Khandelwal P. Are all colloids same? How to select the right colloid? Indian J. Anaesth. 2009; 53: 592–607. PMID: 20640110
  9. Muller L., Le Frant J.Y. Metabolic effects of plasma expanders. Transf. Alt. Transf. Med. 2010; 11 (3): 10–21. DOI: 10.1111/j.1778-428X.2010.01137
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  17. Hilbert-Carius P., Schwarzkopf D., Reinhart K., Hartog C.S., Lefering R., Bernhard M., Struck M.F. Synthetic colloid resuscitation in severely injured patients: analysis of a nationwide trauma registry (TraumaRegister DGU). Scientific Reports. 2018; 8: 11567. DOI: 10.1038/s41598-018-30053-0
  18. Finfer S., Liu B., Taylor C., Bellomo R., Billot L., Cook D. et al.; SAFE TRIPS Investigators. Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units. Crit. Care. 2010; 14: 185. DOI: 10.1186/cc9293
  19. Hartog C.S., Natanson C., Sun J., Klein H.G., Reinhart K. Concerns over use of hydroxyethyl starch solutions. B. M. J. 2014; 349: 5981. DOI: 10.1136/bmj. g5981
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  22. Rasmussen K.C., Secher N.H., Pedersen T. Effect of perioperative crystalloid or colloid fluid therapy on hemorrhage, coagulation competence, and outcome: a systematic review and stratified meta-analysis. Medicine (Baltimore). 2016; 95 (31): 4498. DOI: 10.1097/MD.0000000000004498
  23. Kozek-Langenecker S.A. Effects of hydroxyethyl starch solutions on hemostasis. Anesthesiology. 2005; 103: 654–60. DOI: DOI: 10.1097/00000542-200509000-00031
  24. Bayer O., Schwarzkopf D., Doenst T., Cook D., Kabisch B., Schelenz C. et al. Perioperative fluid therapy with tetrastarch and gelatin in cardiac surgery – a prospective sequential analysis. Crit. Care Med. 2013; 41: 2532–42. DOI: 10.1097/CCM.0b013e3182978fb6 26.
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  26. Farooque S., Kenny M., Marshall S.D. Anaphylaxis to intravenous gelatin-based solutions: a case series examining clinical features and severity. Anaesthesia. 2019; 74 (2): 174–9. DOI: 10.1111/anae.14497
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  29. Food and drug administration. List of drug products that have been withdrawn or removed from the market for reasons of safety or effectiveness. 63 FR 54082. 1998. Available at: https://www.gpo.gov/fdsys/pkg/FR-1998- 10-08/pdf/98-26923.pdf (accessed 30.06.2021)
  30. Moman R.N., Gupta N., Varacallo M. Physiology, albumin. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. PMID: 29083605
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  32. Moret E., Jacob M.W., Ranucci M., Schramko A.A. Albumin – beyond fluid replacement in cardiopulmonary bypass surgery: why, how, and when? Sem. Cardiothorac. Vasc. Anesth. 2014; 18 (3): 252–9. DOI: 10.1177/1089253214535667
  33. Vlasov H., Juvonen T., Hiippala S., Suojaranta R., Peltonen M., Schramko A. et al. Effect and safety of 4% albumin in the treatment of cardiac surgery patients: study protocol for the randomized, double-blind, clinical ALBICS (ALBumin In Cardiac Surgery) trial. Trials. 2020; 21 (1): 235. DOI: 10.1186/s13063-020- 4160-3
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  35. Paar M., Rossmann C., Nusshold C., Wagner T., Schlagenhauf A., Leschnik B. et al. Anticoagulant action of low, physiologic, and high albumin levels in whole blood. PLoS One. 2017; 12 (8): e0182997. DOI: 10.1371/journal.pone.0182997
  36. Rasmussen K.C., Højskov M., Johansson P.I., Kridina I., Kistorp T., Salling L. et al. Impact of albumin on coagulation competence and hemorrhage during major surgery: a randomized controlled trial. Medicine (Baltimore). 2016; 95 (9): e2720. DOI: 10.1097/MD.0000000000002720
  37. Haynes G.R., Bassiri K. Hyper-oncotic vs. hypooncotic albumin solutions: a systematic review of clinical efficacy and safety. SN Compr. Clin. Med. 2021; 3: 1137–47. DOI: 10.1007/s42399-021-00755-0
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  39. Kingeter A.J., Raghunathan K., Munson S.H., Hayashida D.K., Zhang X., Iyengar S. et al. Association between albumin administration and survival in cardiac surgery: a retrospective cohort study. Can. J. Anaesth. 2018; 65 (11): 1218–27. DOI: 10.1007/s12630-018-1181-4
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About Authors

  • Dzhumber Ya. Khinchagov, Cand. Med. Sci., Anesthesiologist-Intensivist; ORCID
  • Mikhail M. Rybka, Dr. Med. Sci., Deputy Director of Anesthesiology and Resuscitation, Head of Department of Anesthesiology and Resuscitation; ORCID

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