Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)—A Randomized Controlled Trial
| Autor: | Reena K. Joshi, Veronique Dinand, Raja Joshi, Manendra Kumar, Mridul Agarwal, A. Rauf, Neeraj Aggarwal |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Heart Defects
Congenital Male Oncotic pressure 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial law Albumins Cardiopulmonary bypass Humans Medicine Postoperative Period Cardiac Surgical Procedures Infusions Intravenous Cardiopulmonary Bypass business.industry Albumin Infant General Medicine 030228 respiratory system Child Preschool Anesthesia Pediatrics Perinatology and Child Health Female Surgery Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | World Journal for Pediatric and Congenital Heart Surgery. 12:61-69 |
| ISSN: | 2150-136X 2150-1351 |
| DOI: | 10.1177/2150135120959088 |
| Popis: | Background: There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes. Methods: Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation. Results: We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×103/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category. Conclusion: High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies. |
| Databáze: | OpenAIRE |
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