Shahidan, Nur Zurairah
(2017)
The effects of 5% albumin and 4% gelatin solution on renal function, haemodynamic stability and blood loss in patient undergoing CABG (coronary artery bypass grafting in HUSM.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: The most ideal approach on cardiopulmonary bypass (CPB) priming and
intravenous fluid choice during Coronary Artery Bypass Grafting (CABG) remains
controversial.
Methods: Thirty four patients undergoing elective CABG were studied. Patients were
excluded if they scheduled for emergency CABG, on known nephrotoxic drug or have a
history of allergy to colloid. Patients were randomly assigned to two groups of 5% albumin
(n=18) and 4% gelatin (n=16). Haemodynamic parameters, serum level of urea, creatinine,
sodium and urine level of sodium and creatinine was measured preoperatively, immediately
after the operation, day 1, 2 and 3 post-operatively. Hemoglobin level was taken
preoperatively, immediately post-operation, day 1 and 2 after operation. Cathecolamines and
vasodilator requirement was also recorded until day 2 post operation. Glomerular filtration
rate (GFR), Fractional Excretion of Sodium (FeNa) was calculated and compared.
Results: mean difference of GFR was significantly higher in 4% gelatin group
throughout the study but the FeNa difference was not statistically significant. On the topic of
haemodynamic stability, the mean arterial blood pressure (MAP) during cardio pulmonary
bypass was significantly higher in 5% albumin group (63.9±3.73 mmHg, P value=0.011).
Cathecolamines and vasodilator requirement showed no remarkable difference. Intraoperative
blood loss was lower in 5% albumin group with mean of 1425.33 (±451.81) mL whereas in
4% gelatin group 1514.44 (±697.67) mL but the difference was not significant(P value=
0.658). Intraoperatively, less blood transfusion was required in 5% albumin group(22.2%)
compared to 4% gelatin group (43.8%)Conclusion: Administration of 5% albumin and 4% gelatin in patients undergoing CABG
showed no remarkable difference on renal function parameters, haemodynamic stability and
blood loss.
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