Hypertonic saline (7.5%) after coronary artery bypass grafting.
OBJECTIVE
Patients undergoing coronary artery bypass grafting often require volume loading after operation. In this situation hypertonic saline may be beneficial in restoring the haemodynamic balance and removing excess extravascular fluid.


METHODS
Forty coronary artery bypass grafting patients were randomly assigned to receive either hypertonic saline 7.5% (20 patients) or 0.9% saline (20 patients) as a single dose of 4 mL kg-1 over 30 min in the postoperative rewarming phase in the intensive care unit.


RESULTS
Mean arterial pressure increased in the hypertonic saline group from 82 +/- 10 (SD) to 104 +/- 17 mmHg (P = 0.002) vs. the normal saline group), and the cardiac index rose from 2.3 +/- 0.5 to 3.4 +/- 0.8 L min-1 m2 (P = 0.002 vs. the normal group). The haemodynamic effect of hypertonic saline lasted only about 1 h. Diuresis was greater in the hypertonic saline group both at 1 h (hypertonic saline: 490 +/- 274 vs. normal saline: 204 +/- 130 mL; P = 0.001) and 10 h (hypertonic saline: 1952 +/- 554 vs. normal saline: 1421 +/- 514 mL; P = 0.003).


CONCLUSIONS
No adverse effects were seen. The hypertonic saline had a strong diuretic effect and may be beneficial in coronary artery bypass graft patients after operations. This is because of its value as a short-term plasma expander and the diuresis eliminates excessive fluid from the body. A larger study is needed to determine whether the benefits outweigh the possible side-effects in these patients.
Järvelä
K
K
Department of Anaesthesia and Intensive Care, Tampere University Hospital, PO Box 2000, FIN-33521 Tampere, Finland.
Kaukinen
S
S
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001810:Blood Volume; D001026:Coronary Artery Bypass; D004231:Diuresis; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D012462:Saline Solution, Hypertonic; D014182:Transplantation, Autologous; D014882:Water-Electrolyte Balance
D012462:Saline Solution, Hypertonic