Hydration before Cardiopulmonary Bypass

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Abstract
A generous fluid regimen before cardiopulmonary bypass (6% of body weight) combined with a vasodilator (nitroprusside) was described recently. The present study deals with central haemodynamics, pulmonary oxygenation, glomerular filtration rate and the use of blood products before and after bypass in patients given crystalloid fluid corresponding to 3% of b.w. before bypass combined with nitroglycerin in a dose that kept pulmonary artery pressure at a constant level. Ten patients with aortic stenosis and/or incompetence were studied. Cardiac output (thermodilution), heart rate, blood pressures, arterial oxygen tension (PaO2) at an inspired oxygen concentration of 30%, the concentration of oxygen in blood and endogenous creatinine clearance were measured. After the induction of neurolept anaesthesia, cardiac index, stroke volume, systemic and pulmonary vascular resistance, pulmonary arteriovenous oxygen difference, PaO2 (FIO2 = 0.3) and glomerular filtration rate were within normal limits. Neither hydration nor the bypass procedure itself caused any change in these parameters. The patients tolerated cannulation of the large vessels well without hypotensive episodes. When compared with a similar group of eight patients treated with a restrictive fluid regimen (0.21 before bypass), no significant differences in the above-mentioned parameters were found.

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