title: Effect of hyperosmolar sodium lactate infusion on haemodynamic status and fluid balance compared with hydroxyethyl starch 6% during the cardiac surgery.
abstract: OBJECTIVE
  No solution has been determined ideal for fluid therapy during cardiac surgery. Previous studies have shown that hyperosmolar sodium lactate (HSL) infusion has improved cardiac performance with smaller volume infusion, which resulted in negative fluid balance. This study compared the effects between a patent-protected HSL infusion and hydroxyethyl starch (HES) 6% on haemodynamic status of the patients undergoing cardiac surgery.
  
  
  METHODS
  In this open-label prospective controlled randomized study, patients were randomly assigned to receive loading dose of either HSL or HES 6%, at 3 mL/kgBW within 15 min, at the beginning of surgery. Haemodynamic parameters and fluid balance were evaluated, while biochemical parameters and any adverse effect were also recorded. Haemodynamic and laboratory parameters were analyzed through repeated measures analysis of variance. Statistical assessment of fluid management was carried out through Student t-test. All statistical analyses were performed using the statistical package for the social sciences(®) version 15, 2006 (SPSS Inc., Chicago, IL).
  
  
  RESULTS
  Out of 100 enrolled patients in this study (50 patients in each arm), 98 patients were included in analysis (50 in HSL group; 48 in HES group). Cardiac index increased higher in HSL group (P = 0.01), whereas systemic vascular resistance index decreased more in HSL than HES group (P = 0.002). Other haemodynamic parameters were comparable between HSL and HES group. Fluid balance was negative in HSL group, but it was positive in HES group (-445.94 ± 815.30 mL vs. +108.479 ± 1219.91 mL, P < 0.009).
  
  
  CONCLUSIONS
  Administration of HSL solution during the cardiac surgery improved cardiac performance and haemodynamic status better than HES did.
authors.affiliation: Department of Anaesthesia and Intensive Care, National Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia.
authors.forename: Cindy Elfir
authors.initials: CE
authors.lastname: Boom
authors.affiliation: Department of Anaesthesia and Intensive Care, National Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia.
authors.forename: Poernomo
authors.initials: P
authors.lastname: Herdono
authors.affiliation: Department of Anaesthesia and Intensive Care, National Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia.
authors.forename: Chairil Gani
authors.initials: CG
authors.lastname: Koto
authors.affiliation: Department of Anaesthesia and Intensive Care, National Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia.
authors.forename: Sjamsul
authors.initials: S
authors.lastname: Hadi
authors.affiliation: Department of Anaesthesia and Intensive Care, National Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia.
authors.forename: I Made Adi
authors.initials: IM
authors.lastname: Permana
keywords: Cardiac surgery; fluid resuscitation; hydroxyethyl starch; hyperosmolar sodium lactate