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The use of mannitol in cardiopulmonary bypass prime solution-Prospective randomized double-blind clinical trial

Ljunggren, Magnus ; Sköld, Andreas ; Dardashti, Alain LU and Hyllén, Snejana LU (2019) In Acta Anaesthesiologica Scandinavica 63(10). p.1298-1305
Abstract

BACKGROUND: The optimal prime solution for the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery has not yet been defined. Mannitol is widely used in the priming solution for CPB despite the fact that there is no clear consensus on the role of mannitol in cardiac surgery. The aim of this study was to investigate the effect of mannitol in the CPB prime solution. METHODS: This prospective, randomized, double-blind study included 40 patients with normal cardiac and renal functions, who underwent coronary artery bypass grafting. One group received a prime based on Ringer's acetate (n = 20), and the other a prime consisting of Ringer's acetate with 200 mL mannitol (n = 20). Changes in osmolality, acid-base status, electrolytes,... (More)

BACKGROUND: The optimal prime solution for the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery has not yet been defined. Mannitol is widely used in the priming solution for CPB despite the fact that there is no clear consensus on the role of mannitol in cardiac surgery. The aim of this study was to investigate the effect of mannitol in the CPB prime solution. METHODS: This prospective, randomized, double-blind study included 40 patients with normal cardiac and renal functions, who underwent coronary artery bypass grafting. One group received a prime based on Ringer's acetate (n = 20), and the other a prime consisting of Ringer's acetate with 200 mL mannitol (n = 20). Changes in osmolality, acid-base status, electrolytes, and renal-related parameters were monitored. RESULTS: No significant differences were found in osmolality between the Ringer's acetate group and the mannitol group at any time. The mannitol group showed a pronounced decrease in sodium, from 138.7 ± 2.8 mmol/L at anaesthesia onset, to 133.9 ± 2.6 mmol/L after the start of CPB (P < .001). No differences were seen in the renal parameters between the groups, apart from a short-term effect of mannitol on peroperative urine production (P = .003). CONCLUSION: We observed no effects on osmolality of a prime solution containing mannitol compared to Ringer's acetate-based prime in patients with normal cardiac and renal function. The use of mannitol in the prime resulted in a short-term, significant decrease in sodium level.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
63
issue
10
pages
8 pages
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:31287556
  • scopus:85073125266
ISSN
0001-5172
DOI
10.1111/aas.13445
language
English
LU publication?
yes
id
2fe9d51b-62d5-4c9c-bd3f-e48cfddeca83
date added to LUP
2019-10-21 11:05:19
date last changed
2020-07-08 05:05:55
@article{2fe9d51b-62d5-4c9c-bd3f-e48cfddeca83,
  abstract     = {<p>BACKGROUND: The optimal prime solution for the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery has not yet been defined. Mannitol is widely used in the priming solution for CPB despite the fact that there is no clear consensus on the role of mannitol in cardiac surgery. The aim of this study was to investigate the effect of mannitol in the CPB prime solution. METHODS: This prospective, randomized, double-blind study included 40 patients with normal cardiac and renal functions, who underwent coronary artery bypass grafting. One group received a prime based on Ringer's acetate (n = 20), and the other a prime consisting of Ringer's acetate with 200 mL mannitol (n = 20). Changes in osmolality, acid-base status, electrolytes, and renal-related parameters were monitored. RESULTS: No significant differences were found in osmolality between the Ringer's acetate group and the mannitol group at any time. The mannitol group showed a pronounced decrease in sodium, from 138.7 ± 2.8 mmol/L at anaesthesia onset, to 133.9 ± 2.6 mmol/L after the start of CPB (P &lt; .001). No differences were seen in the renal parameters between the groups, apart from a short-term effect of mannitol on peroperative urine production (P = .003). CONCLUSION: We observed no effects on osmolality of a prime solution containing mannitol compared to Ringer's acetate-based prime in patients with normal cardiac and renal function. The use of mannitol in the prime resulted in a short-term, significant decrease in sodium level.</p>},
  author       = {Ljunggren, Magnus and Sköld, Andreas and Dardashti, Alain and Hyllén, Snejana},
  issn         = {0001-5172},
  language     = {eng},
  number       = {10},
  pages        = {1298--1305},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {The use of mannitol in cardiopulmonary bypass prime solution-Prospective randomized double-blind clinical trial},
  url          = {http://dx.doi.org/10.1111/aas.13445},
  doi          = {10.1111/aas.13445},
  volume       = {63},
  year         = {2019},
}