Hypertonic Saline for Fluid Resuscitation After Cardiac Surgery
Status:
Completed
Trial end date:
2019-09-30
Target enrollment:
Participant gender:
Summary
Background: Volume replacement strategies and type of fluid used in patients undergoing
cardiac surgery have changed during the last years. Currently used crystalloid solutes have a
variable composition and a major impact on organ function and outcome. Additionally
critically ill patients are prone to fluid overload, which is despite common perception, not
a benign occurrence as it is associated with prolonged ICU- and hospital length of stay and
increased mortality rates. Fluid resuscitation using bolus or continuous infusion of
hypertonic saline was used for more than thirty years. Only a few studies have been conducted
so far, but they showed that infusion of hypertonic saline results in less volume
administered, increased renal function less weight gain in critically ill patients when
compared to other crystalloids.
Aim: This preliminary randomized controlled double-blind study aims to identify whether fluid
resuscitation using hypertonic saline (HS) when used in addition to lactated Ringers solution
results in less total fluid amount administered in patients following cardiac surgery.
Additionally we want to evaluate whether the use of hypertonic saline results less need for
pharmacological cardiocirculatory support, increased renal function, less postoperative
volume overload shortened post-cardiac bypass immune suppression and increased postoperative
outcomes.
Study intervention: At admission to the ICU patients will receive 5ml/kg body weight of 7.3%
NaCl or 0.9% NaCl by infusion pump over 60 minutes. If necessary, fluid resuscitation will
thereafter be performed with Ringer's lactate to normalize peripheral perfusion and to allow
weaning of vasopressors.