Distribution of normal saline and 5% albumin infusions in cardiac surgical patients.

Abstract:

OBJECTIVE:To determine the relative distribution of fluid within the extracellular fluid volume (ECFV) and the effect on oxygen delivery after infusing either normal saline or 5% albumin in cardiac surgical patients. DESIGN:Prospective, randomized, unblinded, interventional study. SETTING:Cardiac surgical intensive care unit in a 450-bed teaching hospital. PATIENTS:Postoperative cardiac surgical patients (n = 40). INTERVENTIONS:Infusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician. MEASUREMENTS AND MAIN RESULTS:Plasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of (131)I-albumin and [(35)S]sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline and 5% albumin increased PV by 9 +/- 23% and 52 +/- 84% of the volume infused, respectively (p <.05), whereas there was no significant difference between saline and albumin in the change in ISFV per volume infused. Only 5% albumin significantly increased cardiac index, although oxygen delivery did not change significantly after either infusion. CONCLUSIONS:In postoperative cardiac surgical patients, infusion of 5% albumin is approximately five times as efficient as a PV expander but has comparable effects on changes in ISFV and oxygen delivery relative to normal saline.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Ernest D,Belzberg AS,Dodek PM

doi

10.1097/00003246-200112000-00011

subject

Has Abstract

pub_date

2001-12-01 00:00:00

pages

2299-302

issue

12

eissn

0090-3493

issn

1530-0293

journal_volume

29

pub_type

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