Fluid and Electrolyte Therapy in Cardiac Surgery

Fluid and Electrolyte Therapy in Cardiac SurgeryNowadays; it is well known that successful perioperative management of patients undergoing surgical procedures consists of a succesful fluid and electrolyte balance. Hence the evaluation and correction of blood, fluid and electrolyte disorders are of great importance for the surgical patients. Besides, as the reasons of these are not known in detail, some precautions in order to prevent patients going under surgical procedures from blood, fluid and electrolyte disorders should be considered. Fluids with different farmacokinetic, and farmacodynamic properties are widely used for the therapy. Not only hemodynamic parameters but also microcirculation, pulmonary functions, erythrocyte rheology, and coagulation cascades should be considered for fluid choice in cardiac surgery patients.To provide an ideal volume replacement therapy during cardiac surgery, the whole process should be considered in three periods; before CPB, CPB period (priming volume) and after CPB and ICU period. The studies for the cardiac surgery patients concerning pre CPB period is limited in number, and the results are incompatieble with each other. These studies are routing the clinicians for the choice of crystalloid, colloid or type of the colloid.Both cristalloids and colloids were shown to be superior over the other solutions in these studies. For this reason, it is impossible to find a clear answer for the type of the fluid to be chosen for today. It can only be conceived that HES is not adviced in CPB as it increases bleeding after CPB.