Clinical Physiology of Circulation

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


Infusion solutions used in off-pump coronary artery bypass

Authors: Khinchagov D.Ya., Rybka M.M., Mumladze K.V., Solovyov N.A., Yudin G.V., Ibragimov R.M., Aidashev Yu.Yu.

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

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DOI: https://doi.org/10.24022/1814-6910-2022-19-4-361-371

UDC: 616.12-005.4-036.12-089.86:615.451.232

Link: Clinical Physiology of Blood Circulaiton. 2022; 4 (19): 361-371

Quote as: Khinchagov D.Ya., Rybka M.M., Mumladze K.V., Solovyov N.A., Yudin G.V., Ibragimov R.M., Aidashev Yu.Yu. Infusion solutions used in off-pump coronary artery bypass. Clinical Physiology of Circulation. 2022; 19 (4): 361–71 (in Russ.). DOI: 10.24022/1814-6910-2022-19-4-361-371

Received / Accepted:  19.11.2022 / 24.12.2022

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Abstract

Objective. To compare infusion therapy with crystalloids and/or their combinations with colloid solutions during the intraoperative period, fluid balance and oxygenating lung function.

Material and methods. Single-center retrospective study including 388 patients with off-pump coronary artery bypass (OPCAB) operated between 2017 and 2018. All patients were divided into 3 groups depending on the infusion solutions used intraoperatively: group 1 with crystalloid-based infusion therapy (CIT) – 197 patients, group 2 with infusion therapy using crystalloids and albumin (AIT) – 47 patients, group 3 with infusion therapy using crystalloids and gelatin (GIT) – 144 patients. A comparison was made of oxygenating lung function, blood lactate concentration, biochemical parameters, mechanical ventilation duration, cardiotonic support, and intraoperative balance.

Results. According to the results of our study, the intraoperative balance in the CIT group was 1358 ± 619 ml, in the AIT group – 1000 (750; 1500) ml, and in the GIT group – 1600 (1063; 2100), which did not reveal significant differences between the CIT and AIT groups, but the CIT and AIT groups were statistically significantly different from the GIT group. By the end of the operation on vasopressor support – doses of norepinephrine, the groups did not differ, despite the use of albumin and gelofusin, which have the effect of increasing plasma volume. The values of partial pressure of arterial blood with oxygen (PaO2) in the postoperative period did not differ significantly in the groups: CIT – 316 (255; 383) mm Hg, AIT – 285.3 ± 91.2 mm Hg, GIT – 310 (253; 355) mm Hg. In the intergroup comparison, no statistically significant difference in the duration of mechanical ventilation (h) was obtained: CIT – 6 (4; 9), AIT – 5 (4; 7) and GIT – 6 (4; 9). Lactate values (mmol/l) by the time of the skin suture were within the acceptable range: KIT – 1.4 (1.1; 1.8), AIT-1.6 (1.2; 2.0) and GIT – 1.5 (1.1; 2.1).

Conclusion. Infusion solutions (crystalloid solutions, albumin and gelatin solutions) used in OPCAB, against the background of minimal blood loss, do not adversely affect the patient's condition, oxygenating lung function and the duration of mechanical ventilation.

About Authors

  • Dzhumber Ya. Khinchagov, Cand. Med. Sci., Anesthesiologist-Intensivist; ORCID
  • Mikhail M. Rybka, Dr. Med. Sci., Head of Department of Anesthesiology and Intensive Care Unit; ORCID
  • Koba V. Mumladze, Anesthesiologist-Intensivist; ORCID
  • Nycolay A. Solovyov, Anesthesiologist-Intensivist; ORCID
  • Gennady V. Yudin, Cand. Med. Sci., Head of the Department of Resuscitation and Intensive Care; ORCID
  • Rustam M. Ibragimov, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
  • Yuris Yu. Aidashev, Anesthesiologist-Intensivist; ORCID

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