title: Hypertonic solution decreases extravascular lung water in cardiac patients undergoing cardiopulmonary bypass surgery.
abstract: OBJECTIVE
  To test the hypothesis that the infusion of hypertonic solution would decrease extravascular lung water postoperatively and thus improve pulmonary function.
  
  
  METHODS
  Prospective, randomized, blinded trial.
  
  
  METHODS
  Tertiary cardiothoracic referral center.
  
  
  METHODS
  Twenty-six patients with coronary artery disease who underwent surgery with cardiopulmonary bypass (CPB).
  
  
  METHODS
  Patients were allocated randomly to receive 4 mL/kg of 7.2% NaCl/hydroxyethyl starch, 200/0.5 (HSH group) or an equal volume of 0.9% NaCl (control group) for 30 minutes starting after anesthesia induction. The extravascular lung water index, hemodynamic and biochemical data, and the rate of complications were analyzed.
  
  
  RESULTS
  The extravascular lung water index was significantly lower (7 v 9.5 mL/kg) in the HSH group at the first postoperative day (p < 0.01). The index of arterial oxygenation efficiency was significantly higher at 5 minutes and 2 and 4 hours after cardiopulmonary bypass (CPB) in the HSH group (p < 0.05). The alveolar-arterial oxygen tension difference was significantly lower at 5 minutes and 2 and 4 hours after CPB in the HSH group (p < 0.01). The cardiac index was significantly higher at 5 minutes after infusion in the HSH group (p < 0.05).
  
  
  CONCLUSIONS
  The infusion of HSH leads to significant decreases in the extravascular lung water index during and after cardiac surgery and is associated with better preservation of pulmonary function and transient increases in the cardiac index. Further trials are needed to clarify the clinical advantages of hypertonic solution administration in patients undergoing surgery with CPB.
authors: Department of Anesthesiology and Intensive Care, Academician EN Meshalkin Novosibirsk State Budget Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors: Vladimir V
authors: VV
authors: Lomivorotov
authors: Evgeniy V
authors: EV
authors: Fominskiy
authors: Sergey M
authors: SM
authors: Efremov
authors: Valeriy A
authors: VA
authors: Nepomniashchikh
authors: Vladimir N
authors: VN
authors: Lomivorotov
authors: Alexander M
authors: AM
authors: Chernyavskiy
authors: Anna N
authors: AN
authors: Shilova
authors: Alexander M
authors: AM
authors: Karaskov
mesh_terms: D000368:Aged; D002302:Cardiac Output / Q000187:drug effects; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003422:Critical Care; D004311:Double-Blind Method; D015633:Extravascular Lung Water / Q000187:drug effects*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D008168:Lung / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010952:Plasma Substitutes / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012964:Sodium / Q000097:blood; D014882:Water-Electrolyte Balance / Q000502:physiology
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic; D012964:Sodium