Isoflurane but Not Mechanical Ventilation Promotes Extravascular Fluid Accumulation during Crystalloid Volume Loading

Abstract

Isoflurane, but not mechanical ventilation, decreased urinary excretion and increased interstitial fluid volume. Volume kinetic analysis indicated "third-space" losses due to isoflurane. Perioperative fluid retention may be associated not only with surgical tissue manipulation, but with anesthesia per se.

Microvascular fluid exchange during pulsatile cardiopulmonary bypass perfusion with the combined use of a nonpulsatile pump and intra-aortic balloon pump

“…The factors responsible for an increase in microvascular fluid filtration include crystalloid hemodilution with a decrease in plasma oncotic pressure, 3 an increase in the central venous pressure (CVP), with elevation of the capillary hydrostatic pressure (Pc), 4 the presence of a generalized inflammatory reaction related to contact between the blood and foreign surfaces of the CPB circuit, 5,6 hypothermic and tepid conditions during CPB, 1,2 the CPB perfusion flow rate, 7 the use of volatile anesthetics, 8 and, finally, the CPB flow pattern (ie, pulsatile vs nonpulsatile perfusion). 9 In a previous study of the fluid exchange in the lungs, fluid filtration, expressed as the filtration coefficient, K f , was found to be higher during pulsatile than nonpulsatile perfusion.…”

A Small Dose of Arginine Vasopressin in Combination with Norepinephrine is a Good Early Treatment for Uncontrolled Hemorrhagic Shock After Hemostasis

“…A great deal of laboratory and clinical research has shown that permissive hypotension, hypothermia, and delayed resuscitation were beneficial to uncontrolled hemorrhagic shock before complete hemostasis (in phase II in the present study), which could prevent blood loss and increase the rescue time for follow-up definitive treatment [2][3][4]. The ideal measures for uncontrolled hemorrhagic shock after bleeding has been controlled (phase III in the present study) are undetermined.…”

“…Most cases of traumatic hemorrhagic shock are uncontrolled hemorrhagic shock. Normotensive resuscitation (resuscitation to maintain normotension) may effectively recover blood pressure and increase tissue perfusion and oxygen delivery [2][3][4], but it could cause hemodilution, clot dislocation, and blood loss for uncontrolled hemorrhagic shock before hemostasis. New fluid resuscitation concepts, including hypotensive, hypothermic, and delayed resuscitation for uncontrolled hemorrhagic shock, have been put forward in recent years and obtained a good effect both in clinical patients or in laboratory [5][6][7][8], but the appropriate treatment modalities for uncontrolled hemorrhagic shock at the early stage after hemostasis has not been determined.…”

Evaluation of Hyperdynamic Resuscitation in 60% TBSA Burn-Injured Sheep

“…Furthermore, our animal models were anesthetized using isoflurane anesthesia during the course of the experiment. Connolly reported that isoflurane anesthesia alone decreases urine output and increases interstitial fluid retention in sheep (30). This effect of isoflurane may have decreased fluid requirements for resuscitation in our model.…”