Key result
Room-temperature albumin lowers blood temperature by ~0.1°C vs body-temperature albumin with similar haemodynamics.
Why the study?
The temperature and haemodynamic effects of room versus body temperature 20% albumin fluid bolus therapy in post-cardiac surgery patients were not well characterized.
Does body temperature 100 mL 20% albumin fluid bolus therapy improve haemodynamic responses compared to room temperature albumin in ventilated post-cardiac surgery patients?
Does body temperature 100 mL 20% albumin fluid bolus therapy improve haemodynamic responses compared to room temperature albumin in ventilated post-cardiac surgery patients?
Absolute Event Rate: -0.1% vs 0%
p-value: p=<0.001
Administering 20% albumin at body temperature prevents a drop in blood temperature but does not significantly alter cardiac index or mean arterial pressure compared to room temperature administration in post-cardiac surgery patients.
Body temperature albumin prevents minor cooling and raises PAP more than room temperature; leaves open any meaningful haemodynamic benefit in post-cardiac surgery patients.
Objective: To study the temperature and haemodynamic effects of room versus body temperature 20% albumin fluid bolus therapy (FBT). Design: Single-centre, prospective, before–after trial. Setting: A tertiary intensive care unit (ICU) in Australia. Participants: Sixty ventilated post-cardiac surgery patients. Intervention: Room versus body temperature 100 mL 20% albumin FBT. Main outcome measures: We recorded haemodynamic data from FBT start to 30 minutes after FBT. The cardiac index (CI) response was defined by a CI increase > 15%, and the mean arterial pressure (MAP) response was defined by a MAP increase > 10%. Outcomes: Immediately after FBT, median blood temperature decreased by −0.1°C (interquartile range [IQR], −0.1 to 0.0°C) with room temperature albumin versus 0.0°C (IQR, −0.1 to 0.0°C) with body temperature albumin ( P < 0.001). The CI or MAP responses were similar. There was, however, a time and study group interaction for blood temperature ( P < 0.001) for absolute and relative changes. In addition, mean pulmonary arterial pressure (PAP) ( P = 0.002) increased more with body temperature albumin and remained higher for most of the observation period. Conclusion: Compared with room temperature albumin FBT, body temperature 20% albumin FBT prevents FBT-associated blood temperature fall and increases mean PAP. However, CI and MAP changes were the similar between the two groups, implying that fluid temperature has limited haemodynamic effects in these patients.
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Yanase et al. (2021) studied ventilated post-cardiac surgery (n=60). Room temperature 20% albumin fluid bolus therapy vs. Body temperature 20% albumin fluid bolus therapy was evaluated on Median blood temperature change immediately after fluid bolus therapy (p=<0.001). Room temperature 20% albumin fluid bolus therapy decreased median blood temperature by -0.1°C compared to 0.0°C with body temperature albumin (P<0.001), with similar haemodynamic effects.
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