Abstract P-539: ALBUMIN VS CRYSTALLOIDS FOR FLUID RESUSCITATION IN CHILDREN AFTER CARDIAC SURGERY

Abstract

Aims & Objectives: To determine the benefit of using colloids vs. crystalloids for volume resuscitation in children after cardiac surgery. Methods Design: Retrospective cohort study. Patients: Children admitted to the Stollery Children’s Hospital pediatric cardiac intensive care unit (PCICU) after cardiac surgery. Intervention: Fluid resuscitation policy change in which crystalloids replaced albumin 5% as the main fluid used for resuscitation after cardiac surgery. Results We compared children having surgery 6 months prior to the policy change (5% albumin group, AG) vs children admitted 6 months after (crystalloid group, CG).Demographic,peri-operative and the following outcome variables (fluid intake day 1 to 4 post-operative,vasoactive therapy,blood products,time to negative fluid balance,dialysis, mechanical ventilation,PCICU and hospital stay) were collected.Data was analysed using multivariate analysis.366 children were included in the study.There was no association between fluid group and fluid intake (ml/kg) on day 1 post-operative (Coef. 2.84; 95%CI -5.37, 11.05; p-value=0.497).However,CG was associated with significantly less fluid intake on day 2 (Coef. -14.9; 95%CI -24.3, -5.57; p-value=0.002) and on the first 48 hours post-operative (Coef. 3.99; 95%CI -27.6, -1.29; p-value=0.032).Mechanical ventilation days (Coef. -1.21; 95%CI -2.19, -0.05; p-value=0.040) and PCICU stay (Coef. -1.29; 95%CI -2.50, -0.08; p-value=0.036) were shorter for the CG,with no significant differences in other outcomes. Conclusions The use of colloids for resuscitation after cardiac surgery was not associated with less fluid intake but rather the opposite. Colloid administration may not provide any clinical benefit after cardiac surgery.