Conservative fluid resuscitation protocol does not reduce the incidence of reoperation for bleeding after emergency CABG

Reoperation for bleeding (ROB) after emergency coronary artery bypass grafting (eCABG) has been identified as an independent risk factor for mortality. Consecutively, the influence of fluid intake, fluid output, fluid balance, blood loss, and inotropic demand on ROB were analyzed. This retrospective...

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Bibliographic Details
Published in:Scientific reports Vol. 14; no. 1; pp. 21037 - 10
Main Authors: Bruno, Jowita, Varayath, Mascha, Gahl, Brigitta, Miazza, Jules, Gebhard, Caroline E., Reuthebuch, Oliver T., Eckstein, Friedrich S., Siegemund, Martin, Hollinger, Alexa, Santer, David
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 09.09.2024
Nature Publishing Group
Nature Portfolio
Subjects:
692/308
692/308/409
Aged
Bleeding
Blood
Bypass
Cardiac surgery
Complications
Coronary artery
Coronary Artery Bypass - adverse effects
Coronary Artery Bypass - methods
Female
Fluid intake
Fluid Therapy - methods
Heart surgery
Humanities and Social Sciences
Humans
Incidence
Male
Middle Aged
multidisciplinary
Norepinephrine
Postoperative
Postoperative bleeding
Postoperative Hemorrhage - epidemiology
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - therapy
Registration
Reoperation
Resuscitation - adverse effects
Resuscitation - methods
Retrospective Studies
Risk Factors
Science
Science (multidisciplinary)
Vasoactive agents
Volume resuscitation protocol
Postoperative bleeding
Volume resuscitation protocol
Cardiac surgery
ISSN:2045-2322, 2045-2322
Online Access:Get full text
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Description
Summary:Reoperation for bleeding (ROB) after emergency coronary artery bypass grafting (eCABG) has been identified as an independent risk factor for mortality. Consecutively, the influence of fluid intake, fluid output, fluid balance, blood loss, and inotropic demand on ROB were analyzed. This retrospective single-center study included 265 patients undergoing eCABG between 2011 and 2020. From 2018, postoperative hemodynamic management was performed with lower volume administration and higher vasoactive support. The primary outcome measure was the incidence of ROB within 48 h according to altered fluid resuscitation strategy. Consecutively, the influence of fluid intake, fluid output, fluid balance, blood loss, and inotropic demand on ROB were analyzed. Incidence of ROB was independent from the volume resuscitation protocol ( P  = .3). The ROB group had a higher perioperative risk, which was observed in EuroSCORE II. Fluid intake ( P  = .021), fluid balance ( P  = .001), and norepinephrine administration ( P  = .004) were associated with ROB. Fluid output and blood loss were not associated with ROB ( P  = .22). Post-test probability was low among all variables. Although fluid management might have an impact on specific postoperative complications, different fluid resuscitation protocols did not alter the incidence of ROB after emergency CABG. Trial registration: www.clinicaltrials.gov registration number NCT04533698; date of registration: August 31, 2020 (retrospectively registered due to nature of the study); URL: https://classic.clinicaltrials.gov/ct2/show/NCT04533698
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-024-71028-8