Cardiac Surgery

Volume expansion with albumin decreases mortality after coronary artery bypass graft surgery.

Sedrakyan A, Gondek K, Paltiel D, Elefteriades JA.

Chest. 2003 Jun;123(6):1853-7.

School of Medicine (Drs. Sedrakyan, Paltiel, and Elefteriades), Yale University, New Haven.

OBJECTIVES: Albumin and nonprotein colloids (starches, dextran, and others) are used frequently as blood volume expanders in coronary artery bypass graft (CABG) surgery. The objective of this study was to determine differences between colloids with regard to patient characteristics and mortality rates. DESIGN AND SETTING: Discharge data collected in the Solucient Clinical Pathways Database from 19,578 patients undergoing CABG surgery were analyzed. MEASUREMENTS: Patients receiving albumin and nonprotein colloids were compared with regard to baseline patient characteristics. A multiple regression model was developed to determine if albumin use was independently associated with mortality rates. RESULTS: Albumin was used in 8,084 cases (41.3%). The use of albumin and nonprotein colloids was not related to patient characteristics. Mortality was lower in the albumin group compared to the nonprotein colloid group (2.47% vs 3.03%, p = 0.02). In the multivariable logistic regression analysis, albumin use was associated with 25% lower odds of mortality compared to nonprotein colloid use (odds ratio, 0.80; 95% confidence interval, 0.67 to 0.96). CONCLUSION: Colloid administration in CABG surgery was unrelated to patient characteristics. Albumin use appears to be associated with lower incidence of mortality after CABG surgery compared to nonprotein colloid use.