Half-molar sodium-lactate solution has a beneficial effect in patients after coronary artery bypass grafting. - Archive ouverte HAL Access content directly
Journal Articles Intensive Care Medicine Year : 2008

Half-molar sodium-lactate solution has a beneficial effect in patients after coronary artery bypass grafting.

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Abstract

OBJECTIVE: To compare two solutions for fluid resuscitation in post-coronary artery bypass grafting (CABG) surgery patients: Ringer's lactate (RL) versus a new solution containing half-molar sodium-lactate (HL). DESIGN: Prospective randomized open label study. SETTING: The first 12 h post-CABG surgery in an intensive care unit (ICU). PATIENTS: There were 230 patients enrolled in the study: 208 were analyzed, with 109 from the HL group and 99 from the RL group. INTERVENTIONS: Patients received over the first 12 h post-CABG 10 ml kg BW(-1) HL solution in the HL group versus 30 ml kg BW(-1) of RL solution in the RL group. MEASUREMENTS AND RESULTS: Hemodynamic status, body fluid balance and inotrope utilization were compared in the two groups. Post-operative cardiac index increase was significantly higher in HL than in RL (P = 0.02), while mean arterial pressure and other hemodynamic parameters were comparable together with urinary output, indicating similar tissue perfusion in both the groups despite a much lower fluid infusion in the HL group. Therefore, a significant negative fluid balance was achieved in the HL but not in the RL group (-790 +/- 71 vs. +43 +/- 115 mL 12 h(-1), P < 0.0001 for HL and RL, respectively). None of the enrolled patients exhibited side effects related to the treatment. CONCLUSION: Half-molar lactate solution is effective for fluid resuscitation in post-CABG patients. Compared to Ringer's Lactate, its use results in a significantly higher cardiac index with less volume being infused, resulting in a very negative post-operative body fluid balance.

Dates and versions

inserm-00388531 , version 1 (26-05-2009)

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Xavier M Leverve, Cindy Boon, Tarmizi Hakim, Maizul Anwar, Erwin Siregar, et al.. Half-molar sodium-lactate solution has a beneficial effect in patients after coronary artery bypass grafting.. Intensive Care Medicine, 2008, 34 (10), pp.1796-803. ⟨10.1007/s00134-008-1165-x⟩. ⟨inserm-00388531⟩

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