We have studied changes in peripheral tissue thickness with a novel hand-held ultrasound device during the perioperative course of 60 healthy surgical patients in three different intraoperative body positions. The nil-by-mouth period led to a significant decrease in forehead tissue thickness. Standardized infusion therapy with Ringer's solution at a rate of 8 ml kg-1 h-1 resulted in a gradual increase in tissue thickness, which was significantly different from preoperative baseline values after 90 min. Packed cell volume decreased significantly after the start of infusion and remained low over the rest of the observation time. Different body positions did not influence changes in tissue thickness. We conclude that changes in perioperative tissue thickness in healthy patients can be detected easily by ultrasound, independent of body position. This method may prove useful for the non-invasive assessment of fluid balance state.
Background: The rate of intercompartmental fluid volume changes during hemodialysis (HD) is a major determinant of dialysis-induced hypotension and lacks direct monitoring. The aim of the study was to evaluate the feasibility of tissue thickness (TT) measurement in monitoring the mobilization of interstitial fluids during HD. Methods: We studied the intradialytic changes in forehead TT and inferior vena cava diameter (IVCD) in 20 patients. Plasma refilling was calculated from changes in hematocrit (Hct) and ultrafiltration rates. Results: During ultrafiltration of 2,437 ± 117 ml (mean ± SEM), Hct increased significantly from 27.9 ± 0.7 to 30.0 ± 0.9%. IVCD decreased significantly from 9.7 ± 0.2 to 6.1 ± 0.4 mm/m2. We found a simultaneously pronounced reduction in TT from 4.46 ± 0.12 to 3.78 ± 0.12 mm (≥15.3%) with a significant correlation to plasma refilling (0.613). Conclusion: Volume changes in the peripheral shell tissues during HD can be monitored directly and noninvasively by A-mode ultrasound.
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