Intraoperative Fluid Balance and Perioperative Outcomes After Aortic Valve Surgery.

The Annals of Thoracic Surgery
Bradford B SmithMark M Smith

Abstract

The effect of intraoperative fluid balance on postoperative acute kidney injury (AKI) in cardiac surgical patients is poorly defined. In this retrospective study of patients undergoing aortic valve replacement for aortic stenosis, the primary outcome of interest was postoperative AKI. Secondary outcomes were postoperative fluid balance, cardiac index, vasopressor use, hospital-free days, stroke, myocardial infarction, hospital readmission, and 30- and 90-day mortality. A total of 2327 patients were analyzed. Positive intraoperative fluid balance was associated with lower odds of AKI; the lowest odds were in the 20- to 39-mL/kg group (odds ratio, 0.56; 95% confidence interval, 0.38-0.81; P = .002). Positive intraoperative fluid balance was associated with a lower postoperative fluid balance. Increased ultrafiltration volume was associated with increased postoperative fluid resuscitation and vasopressor use. AKI was associated with increased 30- and 90-day mortality. Increased fluid balance was associated with increased odds of myocardial infarction and 30-day mortality. Increased ultrafiltration volume was associated with increased odds of 30- and 90-day mortality. In patients who underwent aortic valve replacement for aortic st...Continue Reading

References

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Citations

Aug 21, 2020·BMC Anesthesiology·Alexandre JoostenPhilippe Van der Linden
Oct 16, 2020·The Annals of Thoracic Surgery·Andrew N RosenbaumJacob C Jentzer

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