Fluid shift is moderate and short-lived during acute crystalloid hemodilution and normothermic cardiopulmonary bypass in piglets

• Published in: Acta anaesthesiologica Scandinavica 2005-08, Vol.49 (7), p.949-955
• Main Authors: Farstad, M., Haugen, O., Rynning, S. E., Onarheim, H., Husby, P.
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Cardiopulmonary Bypass; crystalloid hemodilution; Female; fluid balance; fluid shifts; Hemodilution; Isotonic Solutions; Male; Medical sciences; Plasma Substitutes - pharmacology; Plasma Volume; Swine; Water-Electrolyte Balance - physiology
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2005.00743.x

Background:  Crystalloids are commonly used as priming solutions during cardiopulmonary bypass (CPB). Consequently, hemodilution is a regular occurrence at the start of a CPB. This study describes the time‐course variations of hemodynamic parameters, plasma volume (PV) and fluid exchange following crystalloid hemodilution at start of normothermic CPB. Methods:  Forty‐five anesthetized piglets were given 60‐min normothermic CPB. Ringer's solution was used as priming solution and maintenance fluid. Fluid input/losses, PV, colloid osmotic pressures (plasma/interstitium), hematocrit, and s‐proteins were measured, and fluid extravasation rates (FER) and intravascular protein‐masses calculated. Results:  Start of CPB resulted in a 25–30% hemodilution. To keep the fluid level of the CPB‐reservoir constant after start of bypass, fluid addition [2.08 ± 0.36 (mean ± SEM) ml kg−1 min−1] was necessary during the first 5 min. Thereafter the fluid needs to be leveled off [0.17 ± 0.03 ml kg−1 min−1 (10–60 min), P