FLUID THERAPY WITH RINGERS SOLUTION VERSUS HAEMACCEL FOLLOWING CORONARY-ARTERY BYPASS-SURGERY

Background: Crystalloid and colloid infusion can be used in volume the rapy following heart surgery. In this prospective, randomised study we compared Ringer's solution (group R) to Haemaccel (group H) following coronary artery bypass grafting. Methods: A stringent protocol for ad justing the infusion rate was used. Haemodynamic parameters and pulmon ary function were evaluated as well as chest tube drainage. The double -indicator dilution method was used to measure total blood volume inde x (TBVI), intrathoracic blood volume index (ITBVI) and extravascular l ung water index (EVLWI). Results: Haemodynamic stability was achieved in both groups throughout the study period, as judged from mean arteri al pressure, central venous pressure, pulmonary capillary wedge pressu re, and cardiac index. However, the total volume infused was significa ntly higher in group R. TBVI and ITBV were higher in group H, although only significant at 8 h for TBVI. Pulmonary function was similar in b oth groups. There was no significant difference in EVLWI, pulmonary sh unt fraction, and time on mechanical ventilation. Likewise, chest tube drainage was not significantly different in both groups. Conclusion: We conclude that volume therapy with Haemaccel following heart surgery requires less volume and achieves better filling of the circulation c ompared to Ringer's solution. (C) Acta Anaesthesiologica Scandinavica 40 (1996)