Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26413
Title: The hemodynamic effects of warm versus room-temperature crystalloid fluid bolus therapy in post-cardiac surgery patients.
Austin Authors: Bitker, Laurent;Cutuli, Salvatore L ;Yanase, Fumitaka ;Wilson, Anthony;Osawa, Eduardo A;Lucchetta, Luca;Cioccari, Luca;Canet, Emmanuel;Glassford, Neil;Eastwood, Glenn M ;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
University of Melbourne, Parkville, VIC, Australia
Università Cattolica del Sacro Cuore, Facoltà di Medicina e Chirurgia "A. Gemelli", Rome, Italy
Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Service de Médecine Intensive - Réanimation, hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
Intensive Care Unit, Royal Melbourne Hospital, Melbourne Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Australia
Intensive Care
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Melbourne, Australia
Issue Date: 7-May-2021
metadata.dc.date: 2021-05-07
Publication information: Perfusion 2021; online first: 7 May
Abstract: The contribution of fluid temperature to the effect of crystalloid fluid bolus therapy (FBT) in post-cardiac surgery patients is unknown. We evaluated the hemodynamic effects of FBT with fluid warmed to 40°C (warm FBT) versus room-temperature fluid. In this single centre prospective before-and-after study, we evaluated the effects of 500 ml of warm versus room-temperature compound sodium lactate administered over <30 minutes, in 50 cardiac surgery patients admitted to ICU. We recorded hemodynamics continuous before and for 30 minutes after the first FBT. We defined CI responsiveness (CI-R) as an CI increase >15% of baseline immediately after FBT and effect dissipation if the CI returned to <5% of baseline and MAP responsiveness as >10% increase and dissipation as return to <3 mmHg of baseline. Hypotension (56%) and low CI (40%) typically triggered FBT. Temperature decreased >0.3°C in 13 (52%) patients after room-temperature FBT versus 0 (0%) after warm FBT (p < 0.01). CI and MAP responsiveness was similar (16 [64%] versus 11 [44%], p = 0.15 and 15 [60%] versus 17 [68%], p = 0.77, respectively). Among CI responders, CI increased more with room-temperature FBT (+0.6 [IQR, 0.5-1.1] versus +0.5 [IQR, 0.4-0.6] L/min/m2, p = 0.01). However, dissipation was more common after room-temperature versus warm FBT (9/16 [56%] versus 1/11 [9%], p = 0.02). In postoperative cardiac surgery patients, warm FBT preserved core temperature and induced smaller but more sustained CI increases among responders. Fluid temperature appears to impact both core temperature and the duration of CI response.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26413
DOI: 10.1177/02676591211012204
ORCID: 0000-0002-4698-053X
0000-0003-3859-3537
0000-0001-7482-5337
0000-0003-4993-427X
PubMed URL: 33960224
Type: Journal Article
Subjects: cardiac output
cardiac surgery
fluid bolus therapy
physiology
temperature control
Appears in Collections:Journal articles

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