• Roger J Smith, David A Reid, Elizabeth F Delaney, and John D Santamaria.
• Intensive Care, St Vincent's Hospital, Melbourne, VIC. roger.smith@svhm.org.au
• Crit Care Resusc. 2010 Dec 1;12(4):235-41.

ObjectiveTo evaluate the effect of fluid therapy using Accusol (Baxter Healthcare, McGaw Park, Ill, USA), a crystalloid solution containing sodium bicarbonate and other electrolytes and having a strong ion difference of 35 mEq/L, on acid-base stability after cardiac surgery.DesignRetrospective per-protocol comparison.SettingIntensive care unit of St Vincent's Hospital, a teaching hospital in Melbourne, Australia.ParticipantsConsecutive adult patients admitted in daytime hours after elective on-pump coronary artery bypass graft surgery between May and October 2008 constituted the "pre-Accusol group" (n=40), and those admitted between May and October 2009 and who were treated with Accusol constituted the "Accusol group" (n=51).Main Outcome MeasuresThe fluids and their component electrolytes administered; change in standard base excess (SBE) between the time of intensive care admission and 04:00 h the next day.ResultsThe Accusol group received a median Accusol dose of 1.86 mL/kg/h (interquartile range, 1.51-2.20 mL/ kg/h), which accounted for 38% (SD, 10%) of the total volume of fluid administered. The change in SBE was +0.03mmol/L (95% CI, -0.57 to 0.64 mmol/L; P = 0.91) in the Accusol group compared with -2.05mmol/L (95% CI, -2.64 to -1.45; P < 0.01) in the pre-Accusol group. The strong ion difference of the electrolytes administered as components of fluid therapies was higher in the Accusol group by 55.5mEq (95% CI, 40.0 to 71.0mEq; P < 0.01). Only 8% of the Accusol group received albumin compared with 48% of the pre-Accusol group (P < 0.01).ConclusionsSBE was more stable in patients treated with Accusol. Further studies are needed to determine whether use of solutions such as Accusol influences important patient outcomes.

21 keywords...

hide…