Morphological and X-Ray
Microanalytical Changes in Mammalian
Tissue after Overhydration with
Irrigating Fluids

Hahn, Robert G.; Nennesmo, Inger; Rajs, Jovan; Sundelin, Birgitta; Wróblewski, Roumald; Zhang, Weiben

doi:10.1159/000473775

Cited by 36 publications

(20 citation statements)

References 15 publications

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“…Worse yet, lacunae break up the cytoarchitecture in essential organs, such as the heart, which causes cardiac dysfunction that may lead to death. The formation of large lacunae in the myocardium has been demonstrated in animals when isotonic saline is used as comparator to overload with urological irrigating fluids [17,18].…”

Section: Adverse Effects Of Crystalloid Fluidsmentioning

confidence: 99%

Adverse effects of crystalloid and colloid fluids

Hahn¹

2014

Anaesthesiol Intensive Ther

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Guidelines for infusion fluid therapy rarely take into account that adverse effects occur in a dose-dependent fashion. Adverse effects of crystalloid fluids are related to their preferential distribution to the interstitium of the subcutis, the gut, and the lungs. The gastrointestinal recovery time is prolonged by 2 days when more than 2 litres is administered. Infusion of 6-7 litres during open abdominal surgery results in poor wound healing, pulmonary oedema, and pneumonia. There is also a risk of fatal postoperative pulmonary oedema that might develop several days after the surgery. Even larger amounts cause organ dysfunction by breaking up the interstitial matrix and allowing the formation of lacunae of fluid in the skin and central organs, such as the heart. Adverse effects of colloid fluids include anaphylactic reactions, which occur in 1 out of 500 infusions. The possibility that hydroxyethyl starch causes kidney injury in patients other than those with sepsis is still unclear. For both crystalloid and colloid fluids, coagulation becomes impaired when the induced haemodilution has reached 40%. Coagulopathy is aggravated by co-existing hypothermia. Although oedema can occur from both crystalloid and colloid fluids, these differ in pathophysiology. To balance fluid-induced adverse effects, this review suggests that a colloid fluid is indicated when the infused crystalloid volume exceeds 3-4 litres, plasma volume support is still needed, and the transfusion of blood products is not yet indicated.

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Section: Adverse Effects Of Crystalloid Fluidsmentioning

confidence: 99%

Adverse effects of crystalloid and colloid fluids

Hahn¹

2014

Anaesthesiol Intensive Ther

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“…27,28 Larger amounts promote the development of pulmonary edema. 29 Animal studies show that overload with normal saline is associated with tissue damage 30 and a definite death, 31 although it is less harmful than glycine 1.5%. In turn, mannitol 3% is followed by fewer symptoms than absorption of glycine 1.5% in TURP patients.…”

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confidence: 99%

Complications and Clinical Outcome 18 Months After Bipolar and Monopolar Transurethral Resection of the Prostate

Fagerström

Nyman

Hahn

2011

Journal of Endourology

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Purpose: To compare bipolar resection with the conventional monopolar transurethral resection of the prostate (TURP) with respect to peri-and postoperative complications and long-term outcome. Patients and Methods: Patients with consecutive benign prostatic hyperplasia needing surgery (n = 185) from the hospital's waiting list were randomized to TURP using either a bipolar or a monopolar system. Peri-and postoperative parameters were monitored, complications were registered, and timed micturition/International Prostate Symptom Score (TM/IPSS) forms were collected at 3 and 6 weeks and at 6 and 18 months. Results: Bipolar surgery was followed by a 16% to 20% higher percentage of the patients reporting ongoing improvement (fractional IPSS change > 2) at 3 and 6 weeks after the surgery ( p < 0.05). There were fewer readmissions in the bipolar group than in the monopolar (5 vs. 13, p < 0.05). No differences between the groups with respect to hospital stay and catheter duration was recorded. Bipolar and monopolar TURP resulted in marked and sustained improvements of IPSS, bother score, and TM. Conclusions: Bipolar TURP, using the transurethral resection in saline (TURis) system, resulted in significantly fewer postoperative readmissions, faster postoperative recovery, and equally long-lasting good results in TM/ IPSS and bother score, as in monopolar TURP.

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“…Hahn reported on fluid and electrolytes dynamics [38], effect of over-hydration on cardiac muscle [39] and other tissues [40], effect on renal function [41] and compared Glycine to Mannitol. Professor Hahn favoured the toxicity of Glycine as the patho-etiological cause of TURP synbdrome.…”

Section: /8mentioning

confidence: 99%

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2018

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Morphological and X-Ray Microanalytical Changes in Mammalian Tissue after Overhydration with Irrigating Fluids

Cited by 36 publications

References 15 publications

Adverse effects of crystalloid and colloid fluids

Adverse effects of crystalloid and colloid fluids

Complications and Clinical Outcome 18 Months After Bipolar and Monopolar Transurethral Resection of the Prostate

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