Comparing the hemodynamic effects of volume loading vs non-loading during induction of anesthesia in fluid responder patients with coronary artery disease undergoing elective coronary artery bypass graft surgery: a randomized controlled study

Context Postinduction hypotension is a modifiable risk that can be prevented by adjusting the technique for induction of anesthesia. Therefore, volume loading could prevent postinduction hypotension in fluid responder patients. Aims To compare the hemodynamic profile of patients who received volume loading before induction of general anesthesia in patients with CAD undergoing CABG. Settings and design A randomized, controlled, double-blinded trial. Methods and material Patients were randomly divided into two groups; control group were receive nothing before induction, while patients in volume loading group received volume loading of 8 ml/kg Ringer acetate over 10 min. The primary outcome was the incidence of postinduction hypotension from start of induction of anesthesia till 15-minutes after intubation. The two groups were compared according to the following: Incidence of postinduction hypertension, bradycardia, and tachycardia in addition to mean arterial blood pressure, heart rate, stroke volume variation and cardiac index recordings. Results Fifty patient were included in this study. Patients in volume loading group received on average 771±289 ml of acetated ringer before induction of anesthesia to have their SVV below 13%. The incidence of postinduction hypotension was higher in the control group (13/25) compared to volume loading group (5/25) after induction of anesthesia (P<001). Conclusions Volume loading in fluid responder patients undergoing CABG effectively reduced the incidence of hypotension in the first 15 min postinduction period.