Comparison between Crystalloid versus Colloid in ICU Patients After Open-heart Surgery

Rezk, Moataz Elshahat; Abd El-latif, Ahmed Rateb; Rizk, Yousry El-Saied; Elnahas, Ashraf Mostafa

doi:10.21608/bmfj.2024.253749.1975

Comparison between Crystalloid versus Colloid in ICU Patients After Open-heart Surgery

Articles in Press

Document Type : Original Article

Authors

¹ Assistant Professor of Cardiothoracic Surgery Faculty of Medicine, Banha University

² M.B.B.Ch in General Medicine and Surgery) Faculty of Medicine - Cairo University

³ Cardiothoracic Surgery Department-Faculty of Medicine-Benha University

⁴ Assistant Professor of Cardiothoracic Surgery Faculty of Medicine - Benha University

10.21608/bmfj.2024.253749.1975

Abstract

Background: Postoperative hemodynamic instability may lead to cardiovascular morbidity and requires prompt recognition and correction. Possible causes include blood loss, fluid deficit, or sepsis. This study aimed to assess the effect of using colloids versus crystalloids in postoperative cardiac patients requiring fluid volume replacement on mortality, need for blood transfusion or renal replacement therapy, and adverse events. Methods: This randomized, controlled clinical study enrolled 100 patients of cardiac ICU patients who underwent open-heart surgery. Patients were divided into two equal groups: Colloid group: cardiac ICU patients subjected to hypooncotic (e.g., gelatins, and 4 or 5% of albumin) and hyperoncotic (e.g., dextrans, hydroxyethyl starches, and 20 or 25% of albumin) solutions and crystalloids group: cardiac ICU patients subjected to isotonic or hypertonic saline and any buffered solutions. Results: The crystalloid group had significantly lower CVP levels and significantly higher SOFA scores (p < 0.001) compared to the colloid group. Overall mortality rate was significantly higher in the crystalloid group (22%) compared to the colloid group (14%) (p=0.265). a higher percentage of patients in the crystalloid group received mechanical ventilation compared to the colloid group (34% vs 18%), and this difference was statistically significant (p=0.030). Conclusion: The use of colloids for fluid volume replacement in postoperative cardiac patients in the ICU after open-heart surgery showed favorable outcomes compared to crystalloids. The colloid group had lower rates of complications, mortality, and requirements for catecholamines and mechanical ventilation. These findings suggest that colloids may be a more effective choice for fluid resuscitation in this patient population.

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