Original ArticleComparison of the Hemodynamic and Temperature Effects of a 500-mL Bolus of 4% Albumin at Room Versus Body Temperature in Cardiac Surgery Patients
Section snippets
Methods
This study was approved by the ethics committee in Austin Hospital in Melbourne, Australia (reference number LNR/16/Austin/358). The need for informed consent was waived because of the observational nature of the study.
Patients Characteristics
Of the 108 eligible patients, 60 patients without hemodynamic major confounders (30 in each group) were analyzed, and 48 patients were excluded mainly because of changes in norepinephrine dose or sedative drugs (Supplementary Fig 1).
The characteristics of the study patients at baseline were well balanced and are shown in Table 1. More than half of the surgeries were on-pump coronary artery bypass graft, and the median duration of cardio-pulmonary bypass time was similar between the 2 groups.
Key Findings
The authors performed a prospective before-and-after study comparing the hemodynamic and temperature effects of a room temperature (cold) or body temperature (warm) 500-mL bolus of 4% albumin in postoperative cardiac surgery patients using second-to-second measurements. They observed that almost half of the patients in each group achieved an immediate CI-R, with fewer than one-third of these immediate CI-responders showing effect dissipation after 30 minutes. However, the main reason for FBT
Conclusion
In conclusion, cold- albumin FBT immediately lowers core temperature by 0.3°C compared with warm albumin, and the effect continues for up to 30 minutes. Such effect is associated with no differences in CI responsiveness but is associated with significantly different patterns of MAP and mean PAP changes. Furthermore, although these effects are of limited magnitude and probably of limited clinical relevance, they suggest that in hypothermic patients, the administration of warm albumin may be more
Conflict of Interest
F.Y. received a scholarship for a PhD course at Monash University from Japan Student Services Organization and Endeavour scholarship. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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2021, Heart and LungCitation Excerpt :However, when the patient met minor confounders (Supplementary appendix 2), recording continued and the patient was included for analysis. Based previous studies, we estimated the standard deviation (SD) for CI and MAP at 0.65 and 10, respectively.10 We thus estimated that this study would have an 80% power (two sided pvalue of 0.05) to detect differences between the two groups equivalent to 63% of the standard deviation (equivalent to a 6.3 mmHg overall MAP difference and a 0.41 L/min/m2 overall CI difference) if 40 patients were recruited in each group.
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This research did not receive any specific grant from funding agencies in the public, commercial, or non-for-profit sectors.