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RETRACTED ARTICLE: The influence of a balanced volume replacement concept on inflammation, endothelial activation, and kidney integrity in elderly cardiac surgery patients

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This article was retracted on 21 May 2011

Abstract

Purpose

A balanced fluid replacement strategy appears to be promising for correcting hypovolemia. The benefits of a balanced fluid replacement regimen were studied in elderly cardiac surgery patients.

Methods

In a randomized clinical trial, 50 patients aged >75 years undergoing cardiac surgery received a balanced 6% HES 130/0.42 plus a balanced crystalloid solution (n = 25) or a non-balanced HES in saline plus saline solution (n = 25) to keep pulmonary capillary wedge pressure/central venous pressure between 12–14 mmHg. Acid-base status, inflammation, endothelial activation (soluble intercellular adhesion molecule-1, kidney integrity (kidney-specific proteins glutathione transferase-alpha; neutrophil gelatinase-associated lipocalin) were studied after induction of anesthesia, 5 h after surgery, 1 and 2 days thereafter. Serum creatinine (sCr) was measured approximately 60 days after discharge.

Results

A total of 2,750 ± 640 mL of balanced and 2,820 ± 550 mL of unbalanced HES were given until the second POD. Base excess (BE) was significantly reduced in the unbalanced (from +1.21 ± 0.3 to −4.39 ± 1.0 mmol L−1 5 h after surgery; P < 0.001) and remained unchanged in the balanced group (from 1.04 ± 0.3 to −0.81 ± 0.3 mmol L−1 5 h after surgery). Evolution of the BE was significantly different. Inflammatory response and endothelial activation were significantly less pronounced in the balanced than the unbalanced group. Concentrations of kidney-specific proteins after surgery indicated less alterations of kidney integrity in the balanced than in the unbalanced group.

Conclusions

A total balanced volume replacement strategy including a balanced HES and a balanced crystalloid solution resulted in moderate beneficial effects on acid-base status, inflammation, endothelial activation, and kidney integrity compared to a conventional unbalanced volume replacement regimen.

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Acknowledgments

This study was supported only by a hospital grant.

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Corresponding author

Correspondence to Joachim Boldt.

Additional information

This article has been retracted as the IRB approval for the research was misrepresented.

An erratum to this article is available at http://dx.doi.org/10.1007/s00134-011-2220-6.

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Boldt, J., Suttner, S., Brosch, C. et al. RETRACTED ARTICLE: The influence of a balanced volume replacement concept on inflammation, endothelial activation, and kidney integrity in elderly cardiac surgery patients. Intensive Care Med 35, 462–470 (2009). https://doi.org/10.1007/s00134-008-1287-1

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  • DOI: https://doi.org/10.1007/s00134-008-1287-1

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