Patients Undergoing Cardiothoracic Surgery Clinical Trial
Official title:
Does Varying the Chloride Content of Intravenous Fluid Alter the Risk of Acute Kidney Injury After Cardiac Surgery?
This primary aim of this study is to test the impact of a strategy of perioperative
chloride-restriction through intravenous (IV) fluid therapy on the incidence of acute kidney
injury after cardiac surgery.
A prospective, open-label, single-centre 4-period sequential study of varying strategies of
perioperative IV fluid composition will test the hypothesis that a perioperative protocol for
the administration of chloride-poor intravenous fluids compared to chloride-rich intravenous
fluids will reduce the incidence of AKI after adult cardiothoracic surgery.
After an initial run-in period of approximately 1 month (using a chloride-rich fluid strategy), the first study period of 5 months will commence, also comprising a chloride-rich perioperative IV fluid therapy strategy (0.9% saline or 4% albumin). This will include intraoperative fluid and postoperative fluid for the duration of stay in the intensive care unit. This will then be followed by a 1-month transition period before a second period of 5 months will commence where perioperative intravenous fluid therapy will consist of chloride-poor fluids (Lactated Ringer's solution or concentrated 20% albumin). A subsequent 1-month transition period will then be followed by a third period of 5 months characterized by perioperative IV fluid therapy with an alternative combination of chloride-poor solutions (PlasmaLyte® 148 or concentrated 20% albumin). A final 1-month transition period will be followed by a fourth and final period of 5 months characterized by a return to perioperative IV fluid therapy with chloride-rich fluids (0.9% saline or 4% albumin). A final 1-month run-off period using a chloride-rich perioperative fluid strategy will follow prior to study completion. ;