Intraoperative Cell Salvage and Postoperative Acidosis
- Conditions
- Metabolic Acidosis
- Interventions
- Procedure: routine administration of 0.9% sodium chloride
- Registration Number
- NCT02800343
- Lead Sponsor
- University of Edinburgh
- Brief Summary
Metabolic acidosis is a common complication that patients experience in the early postoperative period following cardiac surgery. Increasingly, the composition and volume of intravenous fluids administered during surgery have been implicated in the development of postoperative acidosis. Intraoperative Cell Salvage (ICS), an autologous blood transfusion technique employed by Cardiac/Perfusion Units to minimize blood loss during surgery, involves the infusion of of one such fluid, 0.9% sodium chloride. The rapid infusion of large volumes of 0.9% sodium chloride has previously been linked with the development of hyperchloraemic acidosis. It was therefore hypothesized that the volume of mechanically salvaged of red blood cells re-infused into patients undergoing heart surgery contributes to the acidosis that occurs in the early postoperative period.
To test this, the investigators have designed an observational cohort study to check for correlation between the volume of cell salvaged blood infused during surgery and the severity of postoperative acidosis (which will be assessed using data from routine arterial blood gas samples).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 37
- Age ≥ 18 years
- Patients scheduled for cardiac surgery including both on- and off-pump coronary artery bypass grafting surgery, heart valve surgery, septal surgery, and aortic surgery)
- Patients must have consented to participate
- Patients under 18 years of age
- Patients who are unable or unwilling to provide informed consent
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Cardiovascular surgery routine administration of 0.9% sodium chloride All adult patients undergoing elective or emergency cardiovascular surgery at the study site
- Primary Outcome Measures
Name Time Method plasma hydrogen ion concentration at the start of surgery (before fluid infusion) and immediately after surgery (after fluid infusion) Plasma hydrogen ion concentration is measured by the arterial blood gas analyzer machine, and serves as a direct indicator of plasma acidity at a given time point.
Data from two routine blood gas samples are of interest:
T1 - baseline measurement taken on insertion of an arterial line immediately after the induction of anaesthesia (i.e. before any fluid infusion has commenced); T2 - postoperative measurement made immediately after patient arrives in ICU (i.e. once all the cell salvaged blood has been transfused)
- Secondary Outcome Measures
Name Time Method plasma chloride concentration at the start of surgery (before fluid infusion) and immediately after surgery (after fluid infusion) Plasma chloride concentration is measured by the arterial blood gas analyzer machine.
Data from two routine blood gas samples are of interest:
T1 - baseline measurement taken on insertion of an arterial line immediately after the induction of anaesthesia (i.e. before any fluid infusion has commenced); T2 - postoperative measurement made immediately after patient arrives in ICU (i.e. once all the cell salvaged blood has been transfused)plasma strong ion difference at the start of surgery (before fluid infusion) and immediately after surgery (after fluid infusion) Plasma strong ion difference can be computed from routine arterial blood gas electrolyte measurements (chloride, lactate, sodium, potassium) using a formula.
Strong ion difference serves as an indirect measure of plasma acidity.
Data from two routine blood gas samples are of interest:
T1 - baseline measurement taken on insertion of an arterial line immediately after the induction of anaesthesia (i.e. before any fluid infusion has commenced); T2 - postoperative measurement made immediately after patient arrives in ICU (i.e. once all the cell salvaged blood has been transfused)
Trial Locations
- Locations (1)
Royal Infirmary of Edinburgh
🇬🇧Edinburgh, Midlothian, United Kingdom