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Background: Currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intra- and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. Despite continuing evaluation no superiority of one particular type of fluid has been reached so far. To the best of the investigators' knowledge no study in humans has ever assessed whether the type of crystalloid fluid given for fluid resuscitation in patients undergoing cardiac surgery has an impact on hemodynamic stability and cardiac function so far. Nonetheless in the animal model it was shown that the choice of crystalloid fluid may greatly influence cardiac performance
Primary Aim: In this study the investigators want to clarify whether a balanced type acetate-buffered fluid solution in patients undergoing cardiac surgery is associated with better hemodynamic stability and cardiac function than a lactate-buffered crystalloid solute.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ringer lactate | Active Comparator | Fluid resuscitation will be performed with lactated Ringers during the perioperative period. Perioperative hemodynamic management will be performed according to a specified treatment protocol. |
|
| Ringer acetate | Active Comparator | Fluid resuscitation will be performed with acetated Ringers during the perioperative period. Perioperative hemodynamic management will be performed according to a specified treatment protocol. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| perioperative hemodynamic management with vasoactive medications (norepinephrine, adrenaline ect) | Procedure | Perioperative hemodynamic management will be performed according to a specified treatment protocol. |
| Measure | Description | Time Frame |
|---|---|---|
| Cumulative dose of inopressors (norepinephrine and epinephrine) per kg bodyweight/hour during the perioperative period | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
| Measure | Description | Time Frame |
|---|---|---|
| Time on inopressors | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) | |
| Cumulative dose of inodilators | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Carmen A Pfortmueller, MD | Department of Intensive Care, Bern University Hospital and University of Bern, Bern, Switzerland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Intensive Care, Bern University Hospital and University of Bern, Bern, Switzerland | Bern | 3010 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31060591 | Derived | Pfortmueller CA, Faeh L, Muller M, Eberle B, Jenni H, Zante B, Prazak J, Englberger L, Takala J, Jakob SM. Fluid management in patients undergoing cardiac surgery: effects of an acetate- versus lactate-buffered balanced infusion solution on hemodynamic stability (HEMACETAT). Crit Care. 2019 May 6;23(1):159. doi: 10.1186/s13054-019-2423-8. |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D009638 | Norepinephrine |
| ID | Term |
|---|---|
| D004983 | Ethanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
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| Time on inodilators | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
| Cumulative dose of vasodilatators | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
| Time on vasodilatators | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
| Total amount of fluid | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
| Changes in acid-base status | Perioperative period (induction of anesthesia until extubation in the intensive care unit, usually less than 24 hours)) |
| D000588 |
| Amines |
| D015306 | Biogenic Monoamines |
| D001679 | Biogenic Amines |
| D002395 | Catecholamines |
| D002396 | Catechols |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |