Half-molar sodium-lactate solution has a beneficial effect in patients after coronary artery bypass grafting.
OBJECTIVE
To compare two solutions for fluid resuscitation in post-coronary artery bypass grafting (CABG) surgery patients: Ringer's lactate (RL) versus a new solution containing half-molar sodium-lactate (HL).


METHODS
Prospective randomized open label study.


METHODS
The first 12 h post-CABG surgery in an intensive care unit (ICU).


METHODS
There were 230 patients enrolled in the study: 208 were analyzed, with 109 from the HL group and 99 from the RL group.


METHODS
Patients received over the first 12 h post-CABG 10 ml kg BW(-1) HL solution in the HL group versus 30 ml kg BW(-1) of RL solution in the RL group.


RESULTS
Hemodynamic status, body fluid balance and inotrope utilization were compared in the two groups. Post-operative cardiac index increase was significantly higher in HL than in RL (P = 0.02), while mean arterial pressure and other hemodynamic parameters were comparable together with urinary output, indicating similar tissue perfusion in both the groups despite a much lower fluid infusion in the HL group. Therefore, a significant negative fluid balance was achieved in the HL but not in the RL group (-790 +/- 71 vs. +43 +/- 115 mL 12 h(-1), P < 0.0001 for HL and RL, respectively). None of the enrolled patients exhibited side effects related to the treatment.


CONCLUSIONS
Half-molar lactate solution is effective for fluid resuscitation in post-CABG patients. Compared to Ringer's Lactate, its use results in a significantly higher cardiac index with less volume being infused, resulting in a very negative post-operative body fluid balance.
Leverve
Xavier M
XM
LBFA, INSERM-U884, Université Joseph-Fourier, BP 53 X, 38041 Grenoble Cedex, France. xavier.leverve@ujf-grenoble.fr
Boon
Cindy
C
Hakim
Tarmizi
T
Anwar
Maizul
M
Siregar
Erwin
E
Mustafa
Iqbal
I
D002302:Cardiac Output; D001026:Coronary Artery Bypass; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006982:Hypertonic Solutions / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D000077325:Ringer's Lactate; D019354:Sodium Lactate / Q000378:metabolism / Q000627:therapeutic use*; D014882:Water-Electrolyte Balance / Q000502:physiology
D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D019354:Sodium Lactate