Sharjeel Abbas, Waseem Riaz, Mohd Sharif Nasserry, Madiha Iqbal, Irfan Azmatullah Khwaja, Zafar Tufail.
Association of Positive Intraoperative fluid balance with in-Hospital mortality, in diabetic patients undergoing elective coronary artery revascularization; a Randomized Controlled Trial.
J Cardiovascular Dis Jan ;12(1):17-21.

OBJECTIVE:To evaluate association of intra-operative fluid balance with in-hospital mortality in diabetic patients undergoing elective coronary artery revascularization. METHODS:100 diabetic patients, 35-65 years of age, undergoing coronary artery revascularization from December 2009 to December 2012 were included. They were divided into two groups, Group A had patients with positive fluid balance and Group B had patients with either normal or negative fluid balance. All operations were assisted by first two authors. These patients underwent cardiopulmonary bypass and their input output balance and Hct post CPB was measured along with any blood transfusions peri-operatively. In ICU patients were again monitored for transfusion of blood products. Patients were then divided into two groups, Group A received transfusion while Group B did not. P-values < 0.05 were considered as significant for all tests. RESULTS: Out of hundred patients; (38%) patients had positive fluid balance, while (62%) had normal/ negative fluid balance. Out of 38 positive fluid balance patients undergoing CABG twenty three patients were >61 years of age. The CPB time was >101 min in 35 patients, while cross clamp time was > 101 min in 9 patients. Hct being >45% after CPB in 10 patients and found prolonged (>21 days) postoperative hospital stay in 32(84.2%) patients. The frequency of whole blood and packed cell volume were less in positive fluid balance group than normal/negative fluid balance group, showed insignificant association between blood transfusion and positive fluid balance as P-value < 0.05. A total of 10(26.3%) patients died during the study, only 2 belonged to the group of patients who were transfused. It was noted that all deaths were found in patients having positive fluid balance. CONCLUSION: Positive fluid balance has high mortality rate in diabetic patients undergoing CABG.

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