ScholarLink (思领科)
错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Twenty percent human albumin solution fluid bolus administration therapy in patients after cardiac surgery-II: a multicentre randomised controlled trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年7月2日

查看全文
  • Geoffrey J. Wigmore,
  • Adam M. Deane,
  • Jeffrey J. Presneill,
  • Glenn Eastwood,
  • Ary Serpa Neto,
  • Matthew J. Maiden,
  • Shailesh Bihari,
  • Robert A. Baker,
  • Jayme S. Bennetts,
  • Rashmi Ghanpur,
  • James R. Anstey,
  • Jaishankar Raman,
  • Rinaldo Bellomo,
  • Leah Peck,
  • Helen Young,
  • Will Dovenya,
  • Xu K,
  • Akinori Maeda,
  • Ke Xu,
  • Sofia Spano,
  • Fumitaka Yanase,
  • Helen Young,
  • Michelle Horton,
  • Stephanie Pearce,
  • Paul Power,
  • Jemma Trickey,
  • Deborah Barge,
  • Kathleen Byrne,
  • Michael Haeusler,
  • Chris MacIsaac,
  • Madeleina Snowdon

摘要

Purpose

After cardiac surgery, fluid bolus therapy (FBT) with 20% human albumin may facilitate less fluid and vasopressor administration than FBT with crystalloids. We aimed to determine whether, after cardiac surgery, FBT with 20% albumin reduces the duration of vasopressor therapy compared with crystalloid FBT.

Methods

We conducted a multicentre, parallel-group, open-label, randomised clinical trial in six intensive care units (ICUs) involving cardiac surgery patients deemed to require FBT. We randomised 240 patients to receive up to 400 mL of 20% albumin/day as FBT, followed by 4% albumin for any subsequent FBT on that day, or to crystalloid FBT for at least the first 1000 mL, with use of crystalloid or 4% albumin FBT thereafter. The primary outcome was the cumulative duration of vasopressor therapy. Secondary outcomes included fluid balance.

Results

Of 480 randomised patients, 466 provided consent and contributed to the primary outcome (mean age 65 years; median EuroSCORE II 1.4). The cumulative median duration of vasopressor therapy was 7 (interquartile range [IQR] 0–19.6) hours with 20% albumin and 10.8 (IQR 0–22.8) hours with crystalloids (difference − 3.8 h, 95% confidence interval [CI] − 8 to 0.4; P = 0.08). Day one fluid balance was less with 20% albumin FBT (mean difference − 701 mL, 95% CI − 872 to − 530).

Conclusions

In patients after cardiac surgery, when compared to a crystalloid-based FBT, 20% albumin FBT was associated with a reduced positive fluid balance but did not significantly reduce the duration of vasopressor therapy.