Perioperative Veränderungen der Flüssigkeitsfiltrationskapazität bei gefäßchirurgischen Patienten

Christ, F.; Gamble, J.; Raithel, P.; Steckmeier, B.; Meßmer, K.

doi:10.1007/s001010050662

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…Moreover, capillary filtration is relatively insensitive to interstitial colloid osmotic pressure (9). A lower than normal plasma colloid osmotic pressure will allow extravasation of plasma water, which was reflected in a decrease in Pvi found in both groups and is in agreement with earlier findings of our group, where we reported a reduction in Pvi following induction of anesthesia in patients undergoing vascular surgery (10).…”

Section: Discussionsupporting

confidence: 93%

“…As the surgical trauma in our study was small a protective effect of propofol on microvascular permeability could not be demonstrated. We however, propose that this could be possibly demonstrated with VCP when applied during more traumatizing surgery such as aortic aneurysm repair, which is known to increase the CFC (10). Although propofol shows antioxidant properties in vitro , the clinical importance of this effect remains controversial.…”

Section: Discussionmentioning

confidence: 99%

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Microvascular changes during anesthesia: sevoflurane compared with propofol

Bruegger

Bauer

Finsterer

et al. 2002

Acta Anaesthesiol Scand

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Microvascular changes during anesthesia: sevoflurane compared with propofol

Bruegger

Bauer

Finsterer

et al. 2002

Acta Anaesthesiol Scand

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“…[3] In this regard, there is need for further research to better understand fluid filtration during the perioperative period.…”

Section: Introductionmentioning

confidence: 99%

“…Using VCP at bedside, alterations in fluid filtration have been shown in patients with diabetes, [6] thrombosis, [7] sepsis, [8,9] and patients undergoing major vascular surgery [3] while measurement sites varied among studies. Fluid filtration assessed by VCP can be obtained from forearm and calf measurement sites, while in many clinical situations there is reduced access to the patient often restricting the measurement site to patient's forearm.…”

Section: Introductionmentioning

confidence: 99%

Comparison of bedside assessed arm and leg fluid filtration determined by venous congestion plethysmography in perioperative cancer patients

et al. 2017

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In recent years, pathophysiology and clinical impact of microvascular fluid filtration has regained interest. As the latest data in surgical patients have been published almost 20 years ago, there is need for further research to better understand fluid filtration during the perioperative period. Venous congestion plethysmography (VCP) provides a rapid and noninvasive method, which has been shown suitable for the assessment of fluid filtration in limbs. Fluid filtration assessed by VCP can be obtained from forearm and calf measurement sites, while in many clinical situations a reduced access to the patient often restricts the measurements to patient's forearm. We aimed to investigate if fluid filtration obtained from forearm and calf measurement site is interchangeable in nonsedated perioperative patients.Fluid filtration by VCP was obtained simultaneously from forearm and calf in patients with ovarian cancer at 4 time points during the perioperative course and assessed by the difference of volume changes of the limb between third and sixth minutes (VC6-3min) during venous congestion. VC6-3min obtained from forearm and calf measurement sites was compared with respect to agreement and evaluated regarding the association with the presence of leg edema.A total of 74 paired measurements were analyzed in 29 patients. Forearm VC6-3min was significantly higher than calf VC6-3min (median [25th; 75th quartile], 0.6 (0.4; 0.9) vs 0.4 [0.3; 0.6] %, P = 0.008). Bland–Altman and Polar analysis revealed a poor agreement between forearm and calf VC6-3min at predefined time points and changes of VC6-3min during the perioperative course (bias +0.23%, limits of agreement [LOA] −1.1% to 1.6%; angular bias −2.5°, radial LOA −82° to +77°). Forearm VC6-3min was significantly increased in patients with presence of leg edema (0.7 (0.5; 1.0) vs 0.5 (0.4; 0.6) %, P < 0.001) while calf VC6-3min did not differ in patients with and without edema.This study indicates that forearm and calf measurement sites are not interchangeable when bedside assessing fluid filtration by VCP in nonsedated perioperative patients. Considering that only forearm fluid filtration was related to the presence of edema, forearm measurement site should be chosen as a primary site for assessing fluid filtration.

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Transmembrane water influx via aquaporin-1 is inhibited by barbiturates and propofol in red blood cells

Voigtlaender

Heindl

Becker

2002

Naunyn-Schmiedeberg's Archives of Pharmacology

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Aquaporin-1 (AQP1) is known to be expressed at a high level in endothelial cell membranes and participates in water transfer into or across these cells. To evaluate possible effects of anesthetics on AQP1, a model assessing water permeability of erythrocytes was used, AQP1 being the exclusive water channel in red blood cells (RBC). RBC were suspended in hypertonic (1.35%) or hypotonic (0.45%) phosphate-buffered saline (PBS). Optical density was measured continuously in an aggregometer before and during subsequent addition of hypotonic (0.45%) or hypertonic (9%) PBS, respectively. Rates of change of optical density corresponded to the rate of volume change due to osmotic effects on net water flux across the RBC membrane. We compared actions of mercuric chloride (HgCl(2), definitive AQP1-blocker, 0.2 microM), and different anesthetic drugs, such as thiopental (50-200 microg/ml), phenobarbital (30-220 microg/ml), propofol (15-25 microg/ml), ketamine (3.5-11 microg/ml), midazolam (0.2-32.5 microg/ml), halothane (1.5 vol%), and isoflurane (2.3 vol%); the concentrations being in the one- to threefold range of clinically relevant plasma levels. Water transport into RBC (swelling) was inhibited by HgCl(2), thiopental, phenobarbital and propofol while ketamine, midazolam, halothane, and isoflurane had no effect. Efflux of water (shrinking) was also inhibited by HgCl(2), confirming a significant role of AQP1 in this model. In contrast, none of the tested anesthetic substances had any influence on water efflux. Comparison to chemically related drugs suggested oxidation of a strategic SH-group to be the mode of action. The anesthetics thiopental, phenobarbital, and propofol significantly inhibited influx of water into RBC, while water efflux remained unaffected in distinction to HgCl(2). These anesthetics thus acted as vectorial inhibitors, a hitherto undescribed phenomenon. Accordingly, some anesthetics may indeed affect transport of water via aquaporins.

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Perioperative Veränderungen der Flüssigkeitsfiltrationskapazität bei gefäßchirurgischen Patienten

Cited by 9 publications

References 25 publications

Microvascular changes during anesthesia: sevoflurane compared with propofol

Microvascular changes during anesthesia: sevoflurane compared with propofol

Comparison of bedside assessed arm and leg fluid filtration determined by venous congestion plethysmography in perioperative cancer patients

Transmembrane water influx via aquaporin-1 is inhibited by barbiturates and propofol in red blood cells

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