Table 3.
Preoperative, intraoperative and postoperative therapies
| Total cohort | Control - no bicarbonate | Intervention - bicarbonate | Significance, P-value | |
|---|---|---|---|---|
| Number | 584 | 304 (52.1%) | 280 (47.9%) | |
| Preoperative treatments | ||||
| Beta-blocking agents | 442 (75.8%) | 234 (77.0%) | 208 (74.6%) | 0.558 |
| ACE-inhibitors/ARB | 424 (72.7%) | 225 (74.0%) | 199 (71.3%) | 0.526 |
| Diuretics | 328 (56.4%) | 173 (56.9%) | 155 (55.8%) | 0.844 |
| Vasodilators | 209 (35.8%) | 110 (36.2%) | 99 (35.5%) | 0.929 |
| Phenprocoumon | 11 (1.9%) | 4 (1.3%) | 7 (2.5%) | 0.451 |
| Aspirine | 373 (64.1%) | 203 (66.8%) | 170 (61.2%) | 0.185 |
| Clopidogrel | 53 (9.1%) | 24 (7.9%) | 29 (10.4%) | 0.366 |
| Heparin, intravenous | 95 (16.3%) | 62 (20.4%) | 33 (11.8%) | 0.007 |
| Lipid-lowering drugs | 356 (61.1%) | 197 (64.8%) | 159 (57.0%) | 0.065 |
| Insulin | 64 (11.0%) | 30 (9.9%) | 34 (12.2%) | 0.446 |
| Antibiotics | 64 (11.0%) | 33 (10.9%) | 31 (11.1%) | 0.973 |
| Nitrates, intravenous | 29 (5.0%) | 17 (5.6%) | 12 (4.3%) | 0.599 |
| Levosimendan | 16 (2.7%) | 7 (2.3%) | 9 (3.2%) | 0.669 |
| Intraoperative fluids | ||||
| Cristalline fluids, ml | 1,948 (1,903, 1,993) | 1,982 (,1921, 2,042) | 1,911 (1,844, 1,978) | 0.120 |
| Colloidal fluids, ml | 800 (756, 843) | 791 (730, 852) | 809 (748, 870) | 0.680 |
| Postoperative fluids within 24 h | ||||
| Cristalline fluids, ml | 2,719 (2,667, 2,771) | 2,590 (2,519, 2661) | 2,859 (2,786, 2,933) | < 0.0001 |
| Colloidal fluids, ml | 1,476 (1,412, 1,541) | 1,404 (1,314, 1,494) | 1,555(1,462, 1,647) | 0.022 |
| Intraoperative blood transfusion | ||||
| PRC, patients transfused | 314 (53.8%) | 166 (54.6%) | 148 (52.9%) | 0.734 |
| units transfused | 1 (0, 1) | 1 (0, 1) | 1 (0, 1) | 0.925 |
| FFP, patients transfused | 38 (6.5%) | 20 (6.6%) | 18 (6.4%) | 0.925 |
| units transfused | 0 [0-0] | 0 [0-0] | 0 [0-0] | 0.871 |
| TC, patients transfused | 30 (5.1%) | 16 (5.3%) | 14 (5.0%) | 0.965 |
| units transfused | 0 (0, 0) | 0 (0, 0) | 0 (0, 0) | 0.980 |
| Cellsaver, number patients | 22 (3.8%) | 15 (4.9%) | 7 (2.5%) | 0.185 |
| Postoperative blood transfusion | ||||
| PRC, patients transfused | 253 (43.3%) | 129 (42.4%) | 124 (44.3%) | 0.713 |
| units transfused | 0.00 (0.00, 0.00) | 0.00 (0.00, 0.00) | 0.00 (0.00, 0.88) | 0.505 |
| FFP, patients transfused | 43 (7.4%) | 22 (7.2%) | 21 (7.5%) | 0.971 |
| units transfused | 0.00 (0.00, 0.00) | 0.00 (0.00, 0.00) | 0.00 (0.00, 0.00) | 0.907 |
| TC, patients transfused | 43 (7.4%) | 22 (7.2%) | 21 (7.5%) | 0.980 |
| units transfused | 0.00 (0.00, 0.00) | 0.00 (0.00, 0.00) | 0.00 (0.00, 0.00) | 0.881 |
| Intraoperative vasoactive and inotropic treatments | ||||
| Levosimendan, n (%) | 24 (4.1%) | 11 (3.6%) | 13 (4.6%) | 0.679 |
| Before CPB | 23 (3.9%) | 11 (3.6%) | 12 (4.3%) | 0.531 |
| After CPB | 1 (0.2%) | 0 (0.0%) | 1 (0.4%) | |
| Noradrenaline, n (%) | 522 (89.4%) | 268 (88.2%) | 254 (90.7%) | 0.386 |
| < 0.3 mg/h | 261 (44.7%) | 148 (48.7%) | 113 (40.4%) | 0.069 |
| 0.3 to 0.6 mg/h | 187 (32.0%) | 87 (28.6%) | 100 (35.7%) | |
| > 0.6 mg/h | 74 (12.7%) | 33 (10.9%) | 41 (14.6%) | |
| Vasopressin, n (%) | 49 (8.4%) | 19 (6.2%) | 30 (10.7%) | 0.073 |
| < 3 U/h | 33 (5.7%) | 11 (3.6%) | 22 (7.9%) | 0.109 |
| 3 to 6 U/h | 15 (2.6%) | 8 (2.6%) | 7 (2.5%) | |
| > 6 U/h | 1 (0.2%) | 0 (0.0%) | 1 (0.4%) | |
| Dobutamin, n (%) | 330 (56.5%) | 178 (58.6%) | 152 (54.3%) | 0.339 |
| < 15 mg/h | 130 (22.3%) | 70 (23.0%) | 60 (21.4%) | 0.278 |
| 15 to 30 mg/h | 170 (29.1%) | 96 (31.6%) | 74 (26.4%) | |
| > 30 mg/h | 30 (5.1%) | 12 (3.9%) | 18 (6.4%) | |
| PDE-III inhibitors, n (%) | 249 (42.6%) | 121 (39.8%) | 128 (45.7%) | 0.174 |
| Low dose | 35 (6.0%) | 14 (4.6%) | 21 (7.5%) | 0.126 |
| Moderate dose | 198 (33.9%) | 96 (31.6%) | 102 (36.4%) | |
| High dose | 16 (2.7%) | 11 (3.6%) | 5 (1.8%) | |
| Postoperative vasoactive and inotropic treatment, n (%) | ||||
| Levosimendan | 24 (4.1%) | 12 (3.9%) | 12 (4.3%) | 0.998 |
| Noradrenalin | 494 (84.6%) | 246 (80.9%) | 248 (88.6%) | 0.015 |
| < 0.3 mg/h | 262 (44.9%) | 147 (48.4%) | 115 (41.1%) | 0.0013 |
| 0.3 to 0.6 mg/h | 140 (24.0%) | 58 (19.1%) | 82 (29.3%) | |
| > 0.6 mg/h | 92 (15.8%) | 41 (13.5%) | 51 (18.2%) | |
| Vasopressin | 64 (11.0%) | 29 (9.5%) | 35 (12.5%) | 0.312 |
| < 3 U/h | 49 (8.4%) | 19 (6.2%) | 30 (10.7%) | 0.116 |
| 3 to 6 Uh | 13 (2.2%) | 8 (2.6%) | 5 (1.8%) | |
| > 6 U/h | 2 (0.3%) | 2 (0.7%) | 0 (0.0%) | |
| Dobutamin | 386 (66.1%) | 207 (68.1%) | 179 (63.9%) | 0.330 |
| < 15 mg/h | 184(31.5%) | 97 (31.9%) | 87 (31.1%) | 0.728 |
| 15 to 30 mg/h | 164 (28.1%) | 90 (29.6%) | 74 (26.4%) | |
| > 30 mg/h | 38 (6.5%) | 20 (6.6%) | 18 (6.4%) | |
| PDE III inhibitors | 312 (53.5%) | 156 (51.3%) | 156 (55.9%) | 0.304 |
| Low dose | 60 (10.3%) | 32 (10.5%) | 28 (10.0%) | 0.665 |
| Moderate dose | 224 (38.4%) | 110 (36.2%) | 114 (40.9%) | |
| High dose | 28 (4.8%) | 14 (4.6%) | 14 (5.0%) | |
Perioperative pharmacological treatments are shown for patients undergoing elective on-pump cardiac surgery with or without a perioperative infusion of bicarbonate. ACE-inhibitors: angiotensin converting enzyme inhibitors; ARB: angiotensin receptor blocker; PRC: packed red cells; FFP: fresh frozen plasma; TC: thrombocyte concentrate; PDE-III inhibitors; phosphodiesterase III inhibitors. Data are given as absolute numbers (percentage) for nominal variables, and as median (95% confidence interval) for non-normally distributed data, and mean (95% confidence interval) for normally distributed variables.