When people undergo major surgery, they require intravenous supplementation of fluids for a number of reasons: * to compensate for no oral intake * to support blood pressure and organ function during and after surgery * to replace lost fluid or blood volume There are a variety of fluid choices doctors have to provide to patients, and it is still not definitively known whether some fluids are better than others in specific situations. This is a particularly interesting question in patients undergoing heart surgery because of the significant volume of fluids used over the entire course of hospitalization, including before the operation, during the operation, and after the operation. There has been some scientific evidence that the use of starch-based fluids (synthetic colloids) leads to better oxygen delivery to the organs with a smaller volume of fluid given, providing for better recovery from surgery. However, there has also been some scientific evidence that the use of these fluids can harm kidney function. Importantly, none of these large-scale studies were carried out specifically in patients undergoing heart surgery. The purpose of this study is to answer the question of whether the use of starch-based fluid in the heart surgery patient makes for a safer and faster recovery, causes kidney dysfunction, or makes no discernable difference.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
69
London Health Sciences Centre
London, Ontario, Canada
Incidence of acute kidney injury as defined by RIFLE criteria
Time frame: Short term (in hospital, up to 30 days) and mid-term (2 months)
Maximum postoperative weight gain
Time frame: Short-term (in hospital, up to 7 days)
Operative mortality
Time frame: In hospital (up to 30 days)
Duration of ventilation support requirements
Time frame: In hospital (up to 30 days)
Total chest tube drainage (until removed)
Time frame: In hospital (up to 30 days)
ICU length of stay
Time frame: In hospital (up to 30 days)
Transfusion of blood products
Time frame: In hospital (up to 30 days)
Incidence of atrial fibrillation (necessitating a change in medical management)
Time frame: In hospital (up to 30 days)
Duration of oxygen supplementation
Time frame: In hospital (up to 30 days)
Creatinine, Urea, Cr Clearance as estimated by the MDRD formula
Time frame: In hospital at defined timepoints, and at 2 months post hospital discharge
Volume of fluid infused
Time frame: In hospital (up to 7 days)
Total hospital length of stay (when ready to leave tertiary hospital setting)
Time frame: In hospital
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