Institutions and Affiliations:
Baylor Scott & White Health, 2401 S 31st St, Temple
Texas 76508.
Department of Surgery, Division of Cardiothoracic Surgery.
Baylor Scott & White Health, 2401 S 31st St, Temple
Texas 76508.
Department of Medicine, Division of Cardiology.Meeting Presentation: None.Classification: Original Article.
Word Count: 3451.Corresponding Author: Daniel L. Beckles, MD, PhD, Baylor
Scott & White Health 2401 S 31st St MS-33-NT194,
Temple, Texas 76508. Tel: (254) 724-2334, Fax: (254) 724-1019, email:
Daniel.Beckles@BSWHealth.org
Abstract:
Background: Fluid overload (FO) and acute kidney injury (AKI) after
CABG surgery are due to multiple perioperative etiologies associated
with high failure to rescue rates (FTR) and associated with poor
outcomes 1-,3. Diuretics, fluid restriction,
ultrafiltration (UF) and renal replacement therapies are the treatment
modalities implemented as monotherapy or in combination to address this
severe complication. There is limited data on the use of simplified UF
therapy as a fluid management strategy in post-operative cardiac surgery
patients.
Methods: A retrospective review of our post operative isolated
CABG patients was done from Jan 1st, 2020 to July
31st, 2021. Those subjected to a simplified UF
protocol incorporating Goal Directed Therapy (GDT) to treat fluid
overload and/or acute kidney injury were evaluated for 30-day survival
and readmission rates.
Results: A total of 254
isolated CABG procedures were performed during this period.
Ultrafiltration was used in 17 (6.7%) patients. The 30-day mortality
for the entire CABG cohort was 5/254 (2.0%) patients and in the UF
group 0/17 (0%). The mean age of UF therapy patients was 65.8 years
(Range 41-89). The mean Society of Thoracic Surgeons STS mortality score
of UF patients was 5.7% (Range 0.6-50.0). The 30-day survival for the
17 patients placed on UF therapy was 100% and their readmission rate
was 2/17 (11.7%).
Conclusions: The use of ultrafiltration in this patient
population with relatively high STS scores provided a safe and effective
modality to manage fluid balance but further studies are needed.
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