[Optimization of ventricular function during anesthesia induction by administering crystalloids and colloids to heart surgery patients].
OBJECTIVE
To describe the changes in cardiac function after administration of three different solutions infused after anesthetic induction.


METHODS
Thirty-six patients scheduled for elective aortocoronary bypass surgery were randomly distributed into three groups. Over a period of 25 min after anesthetic induction, 12 received 10 ml/kg of Ringer solution (low dose crystalloid group), 12 received 20 ml/kg of Ringer solution (high dose crystalloid group), and 12 received 10 ml/kg of Ringer solution with 10 ml/kg of hydroxi-ethyl-almidon solution 450,000 D, 0.7 substitution grade (group C-HEA). Minute volume, systemic and pulmonary pressures, osmolality of blood and urine, and plasma and urine sodium concentrations were measured before and after infusion of the assigned liquid.


RESULTS
In spite of the volume infused, low dose crystalloid group showed a high incidence of oliguria, increased urinary osmolality and decreased sodium in urine. Cardiac and systolic indices and left ventricular work load remained stable after infusion of the assigned liquid in low and high dose crystalloid groups, whereas they increased significantly ion group C-HEA (+23%, +16% and +20%).


CONCLUSIONS
Administration of restricted doses of crystalloids after anesthetic induction favors the retention of water and sodium. Higher doses of crystalloids weaken this effect. However, neither of these two regimens leads to a more effective cardiac work load. A combination of crystalloids and colloids administered immediately after anesthetic induction temporarily improves cardiac performance during surgery.
Ballesteros
M
M
Departamento de Anestesia y Cuidados Intensivos, Universidad de Justus-Liebig, Gissen, Alemania.
Boldt
J
J
Zickmann
B
B
Knothe
C
C
Hempelmann
G
G
D000368:Aged; D000758:Anesthesia; D006348:Cardiac Surgical Procedures; D003102:Colloids / Q000494:pharmacology; D004231:Diuresis; D006439:Hemodynamics; D006801:Humans; D007552:Isotonic Solutions / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D000077331:Ringer's Solution; D016276:Ventricular Function / Q000187:drug effects*
D003102:Colloids; D007552:Isotonic Solutions; D000077331:Ringer's Solution
Opitmización de la función ventricular durante la inducción anestésica mediante la administración de cristaloides y coloides en pacientes de cirugía cardíaca.