Background:
Fluid resuscitation during Off-Pump Coronary Surgery (OPCABG) is still not protocolized and depends on multiple variables. We are exploring in this study whether a restrictive or euvolemic approach has any impact on short term surgical outcomes following OPCABG.
Methods:
It is a retrospective study of 300 patients analyzed based on the intraoperative fluid requirement with 150 patients in each group (Group I: Fluid <2 Litres, Group II: Fluid >2 Litres).
Results:
Multivariable analysis showed echocardiography variables such as E/e ratio, LA volume index, and atrial fibrillation (AF). LA volume index is related to the higher fluid requirement. Group II had significantly higher ventilation time (
P
< 0.05), drain output (
P
= 0.05), drain removal time (<0.05), inotropic requirement, and diuretic use.
Conclusion:
The requirement of the intraoperative fluid was associated with various factors including diastolic dysfunction (left atrial volume index, left ventricle mass index, E/e ratio) and preoperative dual antiplatelet use. Group II patients had longer ventilation time, diuretics use, high drain output, and required drains for a longer period of time. Although there was no statistical difference among two groups as far as postoperative AF concerned, a reversal of AF to sinus rhythm was delayed in group II patients.
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