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Title: 20% Human Albumin Solution Fluid Bolus Administration Therapy in Patients After Cardiac Surgery (the HAS FLAIR Study).
Austin Authors: Wigmore, Geoffrey J;Anstey, James R;St John, Ashley;Greaney, Joel;Morales-Codina, Marc;Presneill, Jeffrey J;Deane, Adam M;MacIsaac, Christopher M;Bailey, Michael;Tatoulis, James;Bellomo, Rinaldo 
Affiliation: Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
Department of Medicine and Radiology, University of Melbourne, Australia
University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, Australia
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
Intensive Care
Issue Date: Nov-2019 2019-03-28
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2019; 33(11): 2920-2927
Abstract: To compare the effects of fluid bolus therapy using 20% albumin versus crystalloid on fluid balance, hemodynamic parameters, and intensive care unit (ICU) treatment effects in post-cardiac surgery patients. Sequential period open-label pilot study. University teaching hospital. One hundred adult cardiac surgery patients who were prescribed fluid bolus therapy to correct hypotension or perceived hypovolemia or to optimize cardiac index during the first 24 hours in the ICU. The first 50 patients were treated with crystalloid fluid bolus therapy in the first period (control), and 50 patients with up to 2 treatments of 100 mL of 20% albumin fluid bolus therapy in the second period (intervention), followed by crystalloid therapy if needed. Demographic characteristics were similar at baseline. The intervention was associated with a less positive median fluid balance in the first 24 hours (albumin: 1,100 [650-1,960] v crystalloid: 1,970 [1,430-2,550] p = 0.001), fewer episodes of fluid bolus therapy (3 [2-5] v 5 [4-7]; p < 0.0001) and a lesser volume of fluid bolus therapy (700 [200-1,450] v 1,500 mL/24 h [1,100-2,250]; p < 0.0001). The intervention also was associated with a decreased median overall dose of norepinephrine in the first 24 hours of ICU stay (19 [0-52] v 47 µg/kg/24 hours [0-134]; p = 0.025) and shorter median time to cessation of norepinephrine (17 [5-28] v 28 hours [20-48]; p = 0.002). Post-cardiac surgery fluid bolus therapy with 20% albumin when compared with crystalloid fluid resulted in less positive fluid balance as well as several hemodynamic and potential ICU treatment advantages.
DOI: 10.1053/j.jvca.2019.03.049
ORCID: 0000-0002-1650-8939
PubMed URL: 31097338
Type: Journal Article
Subjects: albumin
cardiac surgery
fluid balance
fluid bolus
Appears in Collections:Journal articles

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