Dehydration and fluid volume kinetics before major open abdominal surgery
2014 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 58, no 10, 1258-1266 p.Article in journal (Refereed) Published
Introduction: Assessment of dehydration in the preoperative setting is of potential clinical value. The present study uses urine analysis and plasma volume kinetics, which have both been validated against induced changes in body water in volunteers, to study the incidence and severity of dehydration before open abdominal surgery begins. Methods: Thirty patients (mean age 64 years) had their urine analysed before major elective open abdominal surgery for colour, specific weight, osmolality and creatinine. The results were scored and the mean taken to represent a dehydration index. Thereafter, the patients received an infusion of 5ml/kg of Ringers acetate intravenously for over 15min. Blood was sampled for 70min and the blood haemoglobin concentration used to estimate the plasma volume kinetics. Results: Distribution of fluid occurred more slowly (Pless than0.01) and the elimination half-life was twice as long (median 40min, not significant) in the 11 patients (37%) diagnosed to be moderately dehydrated as compared with euhydrated patients. The dehydration index indicated that the fluid deficit in these patients corresponded to 2.5% of the body weight, whereas the deficit in the others was 1%. In contrast, the 11 patients who later developed postoperative nausea and vomiting had a very short elimination half-life, only 9min (median, Pless than0.01). These patients were usually euhydrated but had microalbuminuria (Pless than0.03) and higher natriuresis (Pless than0.01). Conclusions: The degree of dehydration before major surgery was modest as evidenced both by urine sampling and volume kinetic analysis.
Place, publisher, year, edition, pages
Wiley-Blackwell, 2014. Vol. 58, no 10, 1258-1266 p.
Anesthesiology and Intensive Care
IdentifiersURN: urn:nbn:se:liu:diva-112464DOI: 10.1111/aas.12416ISI: 000343826500010PubMedID: 25307711OAI: oai:DiVA.org:liu-112464DiVA: diva2:766849
Funding Agencies|County Council of Ostergotland [LiO-314271, LiO-357621]2014-11-282014-11-282015-10-02Bibliographically approved