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The effect of intraoperative Lasix on sodium excretion following cardiac surgery

Objective

To determine the effect of intra-operative Lasix on sodium excretion (NaEx) in children following cardiac surgery after cardiopulmonary bypass (CPB).

Methods

Thirty-six children (median age 5.9 months, range 0.06–182 months) underwent corrective cardiac surgery for congenital heart disease (CHD). The patients were divided into two groups. Group A (n = 12) received 1 mg/kg of intravenous Lasix at the end of the surgical operation, Group B did not receive Lasix and acted as the control group. Urine samples were collected over the 1st (t = 0) and 16th (t = 16) postoperative hour and sent with paired blood samples for electrolyte measurements. Sodium excretion (NaEx) and urine volume (ml/kg/h) was compared between the two groups at t = 0 and t = 16 using the Mann-Whitney test. NaEx was calculated by multiplying urine volume by urine Na concentration and expressed as mmoles/kg/h.

Results

There were no significant differences in age, weight, pre-operative renal function, CPB times or underlying heart disease (cyanotic vs acynotic) between the two groups.

NaEx and urine volume were significantly greater at t = 0 in the group that received Lasix (P = 0.013 and P = 0.001 respectively). These differences were no longer present at the 16th postoperative hour (P = 0.67 and P = 0.38 respectively). In both groups sodium excretion correlated with urine volume (r = 0.98).

Conclusion

Although intraoperative Lasix transiently increases sodium excretion and therefore urine volumes in the immediate post operative period it does not appear to offer any advantage by the 16th postoperative hour, a time when renal water and sodium conservation is maximal.

Figure.
figure1

NaEx plotted against urine volume at t = 0 and t = 16. Blocks indicate median values, whiskers indicate 95%CI.

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Durward, A., Haq, S., Anderson, D. et al. The effect of intraoperative Lasix on sodium excretion following cardiac surgery. Crit Care 3, P210 (2000). https://doi.org/10.1186/cc583

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Keywords

  • Congenital Heart Disease
  • Lasix
  • Cardiopulmonary Bypass
  • Urine Volume
  • Post Operative Period