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Ann Thorac Surg 1978;25:22-29
© 1978 The Society of Thoracic Surgeons

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Articles

The Effect of Hemodilution with Albumin or Ringer's Lactate on Water Balance and Blood Use in Open-Heart Surgery

Cardiac Anesthesia Group of the Department of Anesthesia, the Surgical Cardiovascular Unit of the Department of Surgery, Massachusetts General Hospital, and the Departments of Anesthesia and Surgery, Harvard Medical School, Boston, MA.

Accepted for publication April 1, 1977.

^* Address reprint requests to Dr. Hallowell, Department of Anesthesia, Massachusetts General Hospital, Boston, MA 02114

To determine the effect of intraoperative albumin administration on blood use, water balance, and postoperative clinical course, we studied two groups of adult cardiac surgical patients. Group I (30 patients) received 25 gm of albumin during withdrawal of 2 units of blood prior to cardiopulmonary bypass (CPB) and 50 gm of albumin in the oxygenator prime. Group II (32 patients) received no albumin prior to the end of CPB. No difference in clinical course could be identified, nor was there a significant difference in blood use. Group I patients had lower hematocrit values intraoperatively from the time of blood withdrawal until the conclusion of operation. Coronary artery bypass operations were associated with greater positive water balance than were heart valve operations. Forty-three percent of the patients having coronary artery bypass grafting had a positive water balance greater than 5 liters, whereas 50% of those undergoing valve procedures had a balance less than 3 liters. We conclude that the principal effect of withholding albumin under these circumstances is to increase net positive water balance. The greater positive water balance does not appear to be detrimental.

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