Fluid Balance Calculation Tool for Predicting Postoperative Hematocrit and Intraoperative Blood Loss during Cardiac Surgery
Keywords:
Fluid balance, Predicted Hematocrit, Cardiac Surgery, Cardiopulmonary BypassAbstract
Background and Purpose: Fluid balance management is important in cardiac surgery. During cardiac surgery, patients receive fluid from the anesthesiologist, perfusionist, and surgical field. Greater fluid intake can be obtained from within the surgical field by pumping back through the heart-lung machine. Therefore, it is difficult to calculate the actual fluid balance, which is necessary to predict postoperative hematocrit. Inaccurate calculation of fluid balance can increase the risk of postoperative complications. This study was performed to develop a tool that can calculate the body fluid intake and output of patients undergoing open-heart surgery. The results of the tool can be used to predict postoperative hematocrit and intraoperative blood loss.
Methods: Information technology experts constructed an intake/output chart application, which was used to collect cardiac surgery data at Chulabhorn Hospital during the period from November 2020 to January 2021.
Results: This study included 20 patients (10 men and 10 women; mean age, 68 years). The surgeries consisted of coronary artery bypass graft (CABG) (12 cases, 60%), valve surgery (seven cases, 35%), and combined CABG and valve surgery (one case, 5%). The mean predicted postoperative hematocrit (according to the application) was 33.9%, while the mean actual postoperative hematocrit was 34.06%; these values did not significantly differ (p = 0.064). The mean estimated blood loss during cardiac surgery was 488.40 mL.
Conclusions: Our intake/output chart application can correctly predict postoperative hematocrit and intraoperative blood loss in patients undergoing cardiac surgery
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