AUTHOREA
Log in
Sign Up
Browse Preprints
LOG IN
SIGN UP
Essential Site Maintenance
: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at
[email protected]
in case you face any issues.
Michael M. Koerner
Physician
Oklahoma City
Public Documents
1
The Use of Ultrafiltration in High-Risk Post-operative Coronary Artery Bypass Graftin...
Daniel Beckles
and 6 more
February 05, 2022
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 1 st, 2020 to July 31 st, 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.