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British Journal of Anaesthesia, Vol 79, Issue 3 311-316, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Acute affect of mitral calve replacement on extravascular lung water in patients receiving colloid or crystalloid priming of cardiopulmonary bypass

W. Buhre, A. Hoeft, B. Schorn, A. Weyland, M. Scholz and H. Sonntag
Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin der Universitat Gottingen, Robert-Koch-Str 40, D-37075 Gottingen, Germany; Klinik und Poliklinik fur Anasthesiologie und spezielle Intensivmedizin der Universitat Bonn, Sigmund Freud Str 25, D-53105 Bonn, Germany; Klinik und Poliklinik fur Thorax-, Herz und Gefabetachirurgie der Universitat Gottingen, Robert-Koch-Str 40, D-37075 Gottingen, Germany

Despite numerous studies on extravascular lung water (EVLW) in patients undergoing coronary artery bypass surgery, few data are available on the perioperative time course of EVLW in patients undergoing mitral valve replacement for mitral valve insufficiency (MVI). We have investigated 26 patients undergoing elective mitral valve replacement in order to determine the influence of the preoperative degree of mitral valve insufficiency (degree III or IV) and the effect of different priming solutions for cardiopulmonary bypass. Crystalloid priming with Ringer's lactate was compared with human albumin priming solution. Measurement of EVLW was performed using the thermo-dye dilution technique, before and 1, 6 and 24 h after surgery. Before operation, EVLW is increased significantly in patients with MVI degree IV (MVI-degree IV) compared with patients with degree III (MVI-degree III) and patients undergoing coronary artery bypass surgery. During the postoperative time course a significant decrease in EVLW was observed in patients with MVI-degree IV whereas in patients with MVI-degree III the amount of EVLW did not change. However, compared with patients undergoing coronary artery bypass surgery, EVLW remained above normal in both groups. There was no interaction between the type of priming solution and the postoperative time course of EVLW, and no differences in respiratory variables or duration of mechanical ventilation were observed between groups.
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