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Title: Comparison of the Hemodynamic and Temperature Effects of a 500-mL Bolus of 4% Albumin at Room Versus Body Temperature in Cardiac Surgery Patients.
Austin Authors: Yanase, Fumitaka ;Bitker, Laurent;Lucchetta, Luca;Naorungroj, Thummaporn ;Cutuli, Salvatore L ;Osawa, Eduardo A;Canet, Emmanuel;Wilson, Anthony J;Eastwood, Glenn M ;Bailey, Michael;Bellomo, Rinaldo 
Affiliation: Service de médecine intensive et réanimation, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
Dipartimento di Scienze dell'emergenza, anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
Centre for Integrated Critical Care, School of Medicine, University of Melbourne, Parkville, Victoria, Australia
Department of Intensive Care, Siriraj Hospital, Mahidol University, Bangkok, Thailand..
Department of Intensive Care, Austin Hospital, Melbourne, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Issue Date: 2021
Date: 2020
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2021; 35(2): 499-507
Abstract: To compare the hemodynamic effect of room temperature (cold) 4% albumin fluid bolus therapy (FBT) with body temperature (warm) albumin FBT. Prospective, before-after trial. A tertiary intensive care unit (ICU). Sixty ventilated, post-cardiac surgery patients prescribed with 4% albumin FBT. Cold or warm 4% albumin 500 ml FBT. We recorded hemodynamic parameters before and for 30 minutes after FBT. Cardiac index (CI) and mean arterial pressure (MAP) responses were defined by a CI increase >15% and a MAP increase >10%, respectively. Immediately after FBT, median [interquartile range] core temperature changed by -0.3 [-0.4; -0.3] °C with cold albumin vs. 0.0 [0.0; 0.1]°C with warm albumin (P<0.001). The median CI increase was 0.3 [0.0; 0.5] L/min/m2 with 14 CI-responders (47%) in both groups (P>0.99). The median immediate MAP increase was 9 [3; 15] mmHg with cold albumin vs. 11 [5; 13] mmHg with warm albumin (P=0.79), with a MAP-response in 16 vs. 17 patients (P=0.99). There was an interaction between group and time for MAP (P=0.002), mean pulmonary artery pressure (PAP) (P=0.002) and core temperature (P<0.001). In the cold albumin group, after the initial response, MAP and mean PAP decreased more slowly than with warm albumin and, after the initial fall, core temperature increased toward baseline. In postoperative cardiac surgery patients, warm albumin FBT prevents the decrease in core temperature and, after an initial similar increase, is associated with a faster return of MAP and mean PAP toward baseline.
DOI: 10.1053/j.jvca.2020.06.045
ORCID: 0000-0003-3859-3537
Journal: Journal of Cardiothoracic and Vascular Anesthesia
PubMed URL: 32654806
Type: Journal Article
Subjects: fluid bolus therapy
fluid temperature
iso-oncotic albumin
post cardiac surgery
postoperative care
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