Cardiothoracic & vascular anaesthesia
Impact of Colloid Cardiopulmonary Bypass Priming Strategy on Perioperative Acid-Base Balance in Coronary Artery Bypass Surgery: Physicochemical Analysis of a Double-Blinded Randomized Controlled Study
Authors' conclusion
CPB-induced metabolic acidosis is driven predominantly by reductions in apparent strong ion difference and sustained by unbalanced crystalloid load rather than by colloid choice.
Study context
- Population
- Adults undergoing elective CABG with cardiopulmonary bypass (CPB), tertiary academic teaching hospital170 observations
- Participants
- 34 adults
- Comparison
- Albumin-based vs gelofusine-based vs retrograde autologous CPB priming
- Primary endpoint
- Perioperative acid-base status (Stewart's physicochemical approach; pH, standard base excess, effective strong ion difference)
- Follow-up
- 5 perioperative time points (postinduction to 24 hours post-ICU admission)
Methodological detailssingle-centre, double-blind, 3-arm, 1:1:1 randomisation
- Single-centre
- Double-blind
- 3-arm
- 1:1:1 randomisation
Primary result
As reported in the abstract
pH, standard base excess, effective strong ion difference
Albumin attenuated weak acid-anion dilution
+0.79 mEq/L; p = 0.037
Gelofusine increased the strong ion gap
+2.19 mEq/L; p < 0.001
Further findings
Effect of CPB initiation (all patients)
- pH
- −0.1
- Standard base excess
- −4.3 mmol/L
- Effective strong ion difference
- −6.6 mEq/L
- Substantial metabolic acidosis, driven by reductions in apparent strong ion difference, persisting at 24 hours
Effect of each additional litre of crystalloid
- pH
- −0.011; p = 0.035
- Standard base excess
- −0.99 mmol/L; p = 0.022
- Effective strong ion difference
- −1.03 mEq/L; p = 0.025
- Strong ion gap
- +1.24 mEq/L; p = 0.001
Original publication
Impact of Colloid Cardiopulmonary Bypass Priming Strategy on Perioperative Acid-Base Balance in Coronary Artery Bypass Surgery: Physicochemical Analysis of a Double-Blinded Randomized Controlled Study. J Cardiothorac Vasc Anesth. Published 29 August 2026. doi:10.
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