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Volume turnover kinetics of fluid shifts after hemorrhage, fluid infusion, and the combination of hemorrhage and fluid infusion in sheep
Karolinska University Hospital, Huddinge, Stockholm, Sweden.
University of Texas Medical Branch, USA.
University of Texas Medical Branch, USA.
Karolinska University Hospital, Huddinge, Stockholm, Sweden.
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2005 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 102, no 5, 985-994 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hemorrhage is commonly treated with intravenous infusion of crystalloids. However, the dynamics of fluid shifts between body fluid spaces are not completely known, causing contradictory recommendations regarding timing and volume of fluid infusions. The authors have developed a turnover model that characterizes these fluid shifts.

METHODS: Conscious, chronically instrumented sheep (n = 12) were randomly assigned to three protocol groups: infusion of 25 ml/kg of 0.9% saline over 20 min (infusion only), hemorrhage of 300 ml (7.8 +/- 1.1 ml/kg) over 5 min (hemorrhage only), and hemorrhage of 300 ml over 5 min followed by infusion as noted above (hemorrhage plus infusion). A two-compartment volume turnover kinetic model containing seven model parameters was fitted to data obtained by repeated sampling of hemoglobin concentration and urinary excretion.

RESULTS: The volume turnover model successfully predicted fluid shifts. Mean baseline volumes of the central and tissue compartments were 1799 +/- 1276 ml and 7653 +/- 5478 ml, respectively. Immediate fluid infusion failed to prevent hemorrhage-induced depression of cardiac output and diuresis. The model suggested that volume recruitment to the central compartment after hemorrhage was primarily achieved by mechanisms other than volume equilibration between the two model compartments.

CONCLUSION: Volume turnover kinetics is a promising tool for explaining fluid shifts between body compartments after perturbations such as hemorrhage and intravenous fluid infusions. The pronounced inhibition of renal output after hemorrhage prevailed regardless of fluid infusion and caused fluid retention, which expanded the tissue compartment.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2005. Vol. 102, no 5, 985-994 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-100177DOI: 10.1097/00000542-200505000-00018PubMedID: 15851886OAI: diva2:660661
Available from: 2013-10-30 Created: 2013-10-30 Last updated: 2013-11-07Bibliographically approved

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Hahn, Robert G
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