Objectives
The benefit of using gelatin solution in cardiac surgery is still controversial. Previous
data suggested adverse interactions of gelatin infusion with acute kidney injury (AKI)
or coagulopathy. The purpose of this study was to evaluate the association between
perioperative gelatin use and fluid overload (FO), hemodynamic stability, and outcomes
compared to crystalloid-based fluid management.
Design
A retrospective study design.
Setting
At a single-center tertiary university setting.
Participants
Propensity score-matched cohort study of 191 pairs of patients scheduled for cardiac
surgery.
Interventions
Patients received either gelatin + crystalloid or pure crystalloid-based perioperative
fluid management. The primary outcomes were the frequency of FO and hemodynamic stability
defined by the vasoactive-inotropic score. Postoperative complications and 3-year
survival were analyzed also.
Measurements and Main Results
Patients who received gelatin experienced more frequent postoperative FO than controls
(11.0% v 3.1%, p = 0.006) despite comparable hemodynamic stability in both groups. Gelatin administration
was linked with a higher rate of postoperative complications, including blood loss,
AKI, and new-onset postoperative atrial fibrillation. Use of gelatin infusion resulted
in an adjusted odds ratio of 1.982 (95% CI 1.051-3.736, p = 0.035) for developing early postoperative AKI. This study confirmed a dose-dependent
relationship between gelatin infusion and AKI. Thirty-day mortality and 3-year survival
were similar in the groups.
Conclusions
Gelatin administration versus crystalloid fluid management showed a significant association
with a higher rate of FO and an increased risk for early postoperative AKI in a dose-dependent
manner.
Key Words
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Article info
Publication history
Published online: December 03, 2022
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© 2022 Published by Elsevier Inc.
