Influence of Rate and Volume of Infusion on the Kinetics of 0.9% Saline and 7.5% Saline/6.0% Dextran 70 in Sheep

Brauer, Lance P.; Svensén, Christer; Hahn, Robert G.; Kılıçturgay, Sadık; Kramer, George C.; Prough, Donald S.

doi:10.1097/00000539-200212000-00014

Cited by 20 publications

(28 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The expansion is greater than would be expected based on belief that the water translocated from the ICF by hypertonic glucose is evenly distributed throughout the ECF volume. The small V d for the injected and translocated fluid volumes means that hypertonic glucose is approximately three times more effective than hypertonic saline to expand the plasma volume [7,9,18]. The volume expansion obtained from 30% glucose was also 10 times greater than for Ringer’s acetate solution infused over 30 min in the elderly [17].…”

Section: Discussionmentioning

confidence: 99%

Plasma volume expansion from the intravenous glucose tolerance test before and after hip replacement surgery

Hahn

Nyström

Ljunggren

2013

Theor Biol Med Model

View full text Add to dashboard Cite

BackgroundHyperosmotic glucose is injected intravenously when an intravenous glucose tolerance test (IVGTT) is initiated. The extent and time period of plasma volume expansion that occurs in response to the glucose load has not been studied in the perioperative setting.MethodsTwenty-two non-diabetic patients aged between 57 and 76 years (mean 68) underwent an IVGTT, during which 0.3 g/kg of glucose 30% (1 ml/kg) was injected as a bolus over one minute, one day before and two days after hip replacement surgery. Twelve blood samples were collected over 75 minutes from each patient. The turnover of both the exogenous glucose and the injected fluid volume was calculated by means of mass balance and volume kinetic analysis.ResultsThe IVGTT raised plasma glucose by 9 mmol/L and the plasma volume by 8%. The extracellular fluid volume increased by 320 (SD 60) ml of which 2/3 could be accounted for in the plasma. The half-life of the exogenous glucose averaged 30 minutes before surgery and 36 minutes postoperatively (P < 0.02). The glucose elimination governed 86% of the decay of the plasma volume expansion, which occurred with a half-life of 12 minutes before to 21 minutes after the surgery (median, P < 0.001).ConclusionHyperosmotic glucose translocated intracellular water to the plasma volume rather than to the entire extracellular fluid volume. The preferential re-distribution acts to dilute the plasma concentrations used to quantify insulin sensitivity and ß-cell function from an IVGTT. The greater-than-expected plasma dilution lasted longer after than before surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Plasma volume expansion from the intravenous glucose tolerance test before and after hip replacement surgery

Hahn

Nyström

Ljunggren

2013

Theor Biol Med Model

View full text Add to dashboard Cite

show abstract

“…However, the difference will be reduced with time because the larger peripheral fluid volume gradually becomes diluted, a fact not accounted for in this simplified version of the kinetic model. The nomogram created from the kinetic variables is based on the experience that similar kinetic variables are usually derived regardless of infusion rate and the infused volume of isotonic or nearly isotonic fluid (2,17,18). The results of other studies have been illustrated in the same way (3,9,14).…”

Section: Discussionmentioning

confidence: 99%

The Volume Kinetics of Acetated Ringer???s Solution During Laparoscopic Cholecystectomy

Olsson¹,

Svensén²,

Hahn³

2004

Anesthesia & Analgesia

Self Cite

View full text Add to dashboard Cite

We studied the distribution and elimination of an IV infusion of 20 mL/kg of acetated Ringer's solution (approximately 1500 mL) over 60 min in 12 women undergoing laparoscopic cholecystectomy. A plasma dilution of 4.2% developed during the induction of general anesthesia, even though fluid was withheld. The additional plasma dilution induced by the subsequent volume expansion was slightly larger than expected from previous volunteer experiments and averaged 18%. The diuretic response to intravascular fluid administration was small, and only 20% of the infused fluid had been excreted 4 h later. Volume kinetic analysis showed that the IV fluid expanded a central body fluid space by 3.2 L. The clearance constants for distribution and elimination averaged 115 mL/min and 6.8 mL/min, respectively. These data represent a half-life of the fluid in the patients that is 17 times longer (median, 4.5 h) than the half-life of the plasma dilution (16 min), indicating a strong tendency to the formation of peripheral edema. A nomogram based on the kinetic variables suggests that infusion rates should be relatively rapid early on during surgery but slower later. This strategy creates a constant plasma dilution at any desired level without causing undue peripheral accumulation of fluid.

show abstract

“…This comparison is based on the fact that model linearity has been demonstrated for volume kinetic analysis of crystalloid fluid [20] and in female volunteers receiving Ringer's solution [21]. Some caution about the interpretation is still warranted, however, as the present subjects were pregnant.…”

Section: Kinetic Parametermentioning

confidence: 98%

Distribution and elimination of crystalloid fluid in pre-eclampsia

Drobin

Hahn

2004

Clinical Science

Self Cite

View full text Add to dashboard Cite

Pre-eclampsia (PE) is a disease of pregnancy associated with peripheral oedema and hypovolaemia, but few details are known about how women with PE handle a volume load of crystalloid fluid compared with healthy pregnant women. To study this issue, Ringer's acetate solution (12.5 ml/kg of body weight) was given by intravenous infusion over 30 min to eight women with PE and to eight healthy pregnant women matched with respect to gestational week (mean, 34 weeks). Venous blood was sampled and excreted urine was collected over 90 min to study the time course of the volume expansion by means of volume kinetic analysis. The results show that the size of the central body fluid space expanded by the infused fluid was smaller in PE (mean, 2940 ml compared with 4240 ml respectively; P<0.04), and the clearance constants for distribution (100 ml/min compared with 43 ml/min; P<0.04) and elimination (125 ml/min compared with 36 ml/min; P<0.02) were higher in the women with PE than in the controls. Less excess volume accumulated in the central body fluid space in the presence of PE, whereas the rates of distribution and elimination were higher during and for 15 min after the infusion. It is concluded that Ringer's acetate solution fluid is both distributed and eliminated faster in women with PE than in matched pregnant controls.

show abstract

Influence of Rate and Volume of Infusion on the Kinetics of 0.9% Saline and 7.5% Saline/6.0% Dextran 70 in Sheep

Abstract: Kinetic analysis of a short infusion of 7.5% saline/6% dextran or 0.9% saline accurately predicts the effects of a longer infusion of the same volume (7.5% saline/6% dextran) or of a larger volume (0.9% saline).

Cited by 20 publications

References 19 publications

Plasma volume expansion from the intravenous glucose tolerance test before and after hip replacement surgery

Plasma volume expansion from the intravenous glucose tolerance test before and after hip replacement surgery

The Volume Kinetics of Acetated Ringer???s Solution During Laparoscopic Cholecystectomy

Distribution and elimination of crystalloid fluid in pre-eclampsia

Contact Info

Product

Resources

About