Cardiothoracic & vascular anesthesia
Perioperative fluid management for adult cardiac surgery: network meta-analysis pooling on twenty randomised controlled trials
Authors' conclusion
This study showed that 3% gelatin and 5% albumin can reduce the transfuse RBC and FFP. In addition, the use of hypertonic saline solution can increase urine output, and 5% albumin and 6% HES can shorten the length of ICU stay. However, none of the perioperative fluids showed an objective advantage in various outcomes, including mortality, transfuse PLA, postoperative chest tube output over the first 24 h following surgery, and length of hospital stay.
Study context
- Population
- Adult cardiac surgery patients receiving perioperative fluid therapytwenty RCTs
- Comparison
- Perioperative colloids and crystalloids compared with each other
- Outcome
- Mortality, platelet transfusion, chest tube output first 24 h, hospital LOS
Methodological detailsOvid MEDLINE, EMBase and Cochrane CENTRAL searched up to February 15, 2023
- Ovid MEDLINE, EMBase and Cochrane CENTRAL searched up to February 15, 2023
Pooled result
As reported in the abstract
- None of the network comparisons statistically significant
Further pooled results
RBC transfusion
- Significant differences: 3% gelatine vs 6% HES 200/0.5, 4% albumin vs 5% albumin, 4% gelatine vs 5% albumin, 5% albumin vs 6% HES 200/0.5, 6% HES 130/0.4 vs 6% HES 200/0.5
FFP transfusion
- Significant differences: 3% gelatine vs 4% gelatine, 3% gelatine vs 6% HES 200/0.5, 5% albumin vs 6% HES 200/0.5, 4% gelatine vs 5% albumin, 4% gelatine vs 6% HES 200/0.4, 6% HES 130/0.4 vs 6% HES 200/0.5
AKI, serum creatinine, serum microglobulin, blood urea nitrogen
- Direct comparison only, due to small number of included studies
Original publication
Perioperative fluid management for adult cardiac surgery: network meta-analysis pooling on twenty randomised controlled trials. Perioper Med (Lond). Published 20 July 2024. doi:10.
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