TY - JOUR
T1 - Intra-operative colloid administration increases the clearance of a post-operative fluid load
AU - Borup, Tine
AU - Hahn, Robert
AU - Holte, K
AU - Ravn, L
AU - Kehlet, H
N1 - Keywords: Adult; Aged; Cholecystectomy; Colloids; Female; Hetastarch; Humans; Infusions, Intravenous; Intraoperative Care; Kinetics; Lactic Acid; Laparoscopy; Male; Middle Aged; Postoperative Period
PY - 2009
Y1 - 2009
N2 - BACKGROUND: It is unknown whether an intra-operative colloid infusion alters the dynamics of a crystalloid load administered post-operatively. METHODS: Ten patients received 12.5 ml/kg of Ringer's lactate over 30 min 1-3 days before and 4 h after laparoscopic cholecystectomy, during which 10 ml/kg of a colloid solution, hydroxyethylstarch (HES 130/0.4), was infused. The total body clearance of the pre- and post-operative test infusions was taken as the ratio between the urinary excretion and the Hb-derived dilution of venous plasma over 150 min. The plasma clearance of the infused fluid was calculated using volume kinetics based on the plasma dilution alone. The pre-operative plasma clearance was compared with the post-operative plasma clearance and patients served as their own control. RESULTS: The urinary excretion averaged 350 ml for the pre-operative infusion and 612 ml post-operatively, which corresponds to 46% and 68% of the pre- and post-operative infusions, respectively. The total body clearance of the crystalloid fluid was 30 ml/min before surgery and 124 ml/min after surgery (P<0.01). The plasma clearance, as obtained from the plasma dilution alone, was 28 and 412 ml/min, respectively. The maximal increase in plasma volume was 410 ml pre-operatively vs. 220 ml post-operatively. CONCLUSIONS: Infusion of a colloid solution in combination with a crystalloid during laparoscopic cholecystectomy increased the plasma clearance of a post-operative crystalloid infusion.
AB - BACKGROUND: It is unknown whether an intra-operative colloid infusion alters the dynamics of a crystalloid load administered post-operatively. METHODS: Ten patients received 12.5 ml/kg of Ringer's lactate over 30 min 1-3 days before and 4 h after laparoscopic cholecystectomy, during which 10 ml/kg of a colloid solution, hydroxyethylstarch (HES 130/0.4), was infused. The total body clearance of the pre- and post-operative test infusions was taken as the ratio between the urinary excretion and the Hb-derived dilution of venous plasma over 150 min. The plasma clearance of the infused fluid was calculated using volume kinetics based on the plasma dilution alone. The pre-operative plasma clearance was compared with the post-operative plasma clearance and patients served as their own control. RESULTS: The urinary excretion averaged 350 ml for the pre-operative infusion and 612 ml post-operatively, which corresponds to 46% and 68% of the pre- and post-operative infusions, respectively. The total body clearance of the crystalloid fluid was 30 ml/min before surgery and 124 ml/min after surgery (P<0.01). The plasma clearance, as obtained from the plasma dilution alone, was 28 and 412 ml/min, respectively. The maximal increase in plasma volume was 410 ml pre-operatively vs. 220 ml post-operatively. CONCLUSIONS: Infusion of a colloid solution in combination with a crystalloid during laparoscopic cholecystectomy increased the plasma clearance of a post-operative crystalloid infusion.
U2 - 10.1111/j.1399-6576.2008.01857.x
DO - 10.1111/j.1399-6576.2008.01857.x
M3 - Journal article
C2 - 19243316
SN - 0001-5172
VL - 53
SP - 311
EP - 317
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 3
ER -