Observational studyBrazilian journal of anesthesiology (Elsevier)
Intraoperative fluid balance and cardiac surgery-associated acute kidney injury: a multicenter prospective study.
Observational study in Brazilian journal of anesthesiology (Elsevier). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Early Postoperative Complications and Risk Assessment in Cardiac Surgery: A Cohort Study.Annals of cardiac anaesthesia · 2026Article
- Perioperative fluid accumulation and clinical outcomes after cardiac surgery: a systematic review and Bayesian meta-analysis.Journal of anesthesia, analgesia and critical care · 2026Review
- Complication patterns and postoperative outcomes in surgical patients admitted to intensive care units.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Lactate-to-albumin ratio index correlates with the occurrence and prognosis of acute kidney injury complicated by cardiac surgery.International journal of cardiology. Heart & vasculature · 2025Article
- Observational
- Effect of restrictive cumulative fluid balance on 28-day survival in invasively ventilated patients with moderate to severe ARDS due to COVID-19.Scientific reports · 2023Article
- Fluid management strategies and their interaction with mechanical ventilation: from experimental studies to clinical practice.Intensive care medicine experimental · 2023Review
- Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery.Journal of cardiovascular development and disease · 2023Article
- Diagnosis, pathophysiology and preventive strategies for cardiac surgery-associated acute kidney injury: a narrative review.European journal of medical research · 2023Review
- A system theory based digital model for predicting the cumulative fluid balance course in intensive care patients.Frontiers in physiology · 2023Article
- Perioperative fluid therapy: more questions than definitive answers.Brazilian journal of anesthesiology (Elsevier)Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent data suggest the regime of fluid therapy intraoperatively in patients undergoing major surgeries may interfere in patient outcomes. The development of postoperative Acute Kidney Injury (AKI) has been associated with both Restrictive Fluid Balance (RFB) and Liberal Fluid Balance (LFB) during non-cardiac surgery. In patients undergoing cardiac surgery, this influence remains unclear. The study objective was to evaluate the relationship between intraoperative RFB vs. LFB and the incidence of Cardiac-Surgery-Associated AKI (CSA-AKI) and major postoperative outcomes in patients undergoing on-pump Coronary Artery Bypass Grafting (CABG).
methodsThis prospective, multicenter, observational cohort study was set at two high-complexity university hospitals in Brazil. Adult patients who required postoperative intensive care after undergoing elective on-pump CABG were allocated to two groups according to their intraoperative fluid strategy (RFB or LFB) with no intervention.
resultsThe primary endpoint was CSA-AKI. The secondary outcomes were in-hospital mortality, cardiovascular complications, ICU Length of Stay (ICU-LOS), and Hospital LOS (H-LOS). After propensity score matching, 180 patients remained in each group. There was no difference in risk of CSA-AKI between the two groups (RR = 1.15; 95% CI, 0.85-1.56, p = 0.36). The in-hospital mortality, H-LOS and cardiovascular complications were higher in the LFB group. ICU-LOS was not significantly different between the two groups. ROCcurve analysis determined a fluid balance above 2500 mL to accurately predict in-hospital mortality.
conclusionPatients undergoing on-pump CABG with LFB when compared with patients with RFB present similar CSA-AKI rates and ICU-LOS, but higher in-hospital mortality, cardiovascular complications, and H-LOS.
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