Randomized clinical trial of intravenous fluid replacement during bowel preparation for surgery

Sanders, Grant; Mercer, Simon; Saeb-Parsey, K; Akhavani, Mohammed Ali; Hosie, K. B.; Lambert, A W

doi:10.1046/j.0007-1323.2001.01872.x

Cited by 86 publications

(43 citation statements)

References 5 publications

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“…In support of these data, increases in the concentration of hemoglobin [18] , hematocrit and serum osmolality [15] have been reported. Several authors have stated that maintaining appropriate hydration is possible to dilute the urine, and reduce its calcium and phosphate concentration [19,20] .…”

Section: Discussionsupporting

confidence: 55%

Hyperphosphatemia after sodium phosphate laxatives inlow risk patients: Prospective study

Casais¹,

Rosa-Díez²,

Pérez³

et al. 2009

WJG

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AIM:To establish the frequency of hyperphosphatemia following the administration of sodium phosphate laxatives in low-risk patients. METHODS:One hundred consecutive ASA Ⅰ-Ⅱ individuals aged 35-74 years, who were undergoing colonic cleansing with oral sodium phosphate (OSP) before colonoscopy were recruited for this prospective study. Exclusion criteria: congestive heart failure, chronic kidney disease, diabetes, liver cirrhosis, intestinal obstruction, decreased bowel motility, increased bowel permeability, and hyperparathyroidism. The day before colonoscopy, all the participants entered a 24-h period of diet that consisted of 4 L of clear fluids with sugar or honey and 90 mL (60 g) of OSP in two 45-mL doses, 5 h apart. Serum phosphate was measured before and after the administration of the laxative. RESULTS:The main demographic data (mean ± SD) were: age, 58.9 ± 8.4 years; height, 163.8 ± 8.6 cm; weight, 71 ± 13 kg; body mass index, 26 ± 4; women, 66%. Serum phosphate increased from 3.74 ± 0.56 to 5.58 ± 1.1 mg/dL, which surpassed the normal value (2.5-4.5 mg/dL) in 87% of the patients. The highest serum phosphate was 9.6 mg/dL. Urea and creatinine remained within normal limits. Post-treatment OSP serum phosphate concentration correlated inversely with glomerular filtration rate (P < 0.007, R 2 = 0.0755), total body water (P < 0.001, R 2 = 0.156) and weight (P < 0.013, R 2 = 0.0635). CONCLUSION:In low-risk, well-hydrated patients, the standard dose of OSP-laxative-induced hyperphosphatemia is related to body weight.

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Section: Discussionsupporting

confidence: 55%

Hyperphosphatemia after sodium phosphate laxatives inlow risk patients: Prospective study

Casais¹,

Rosa-Díez²,

Pérez³

et al. 2009

WJG

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“…Patients receiving preoperative bowel preparation for colo-rectal procedures can be moderately dehydrated (1-2 litres) or have major electrolyte imbalance (Beloosesky et al 2003;Seinela et al 2003). Careful concurrent administration of either intravenous (Sanders et al 2001) or oral rehydration solutions (Barclay et al 2002) may help to restore balance.…”

Section: Consequences Of Salt and Water Imbalancementioning

confidence: 99%

Fluid, electrolytes and nutrition: physiological and clinical aspects

Lobo

2004

Proc. Nutr. Soc.

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Fluid and electrolyte balance is often poorly understood and inappropriate prescribing can cause increased post-operative morbidity and mortality. The efficiency of the physiological response to a salt or water deficit, developed through evolution, contrasts with the relatively inefficient mechanism for dealing with salt excess. Saline has a Na + :Cl -of 1 :1 and can produce hyperchloraemic acidosis, renal vasoconstriction and reduced glomerular filtration rate. In contrast, the more physiological Hartmann's solution with a Na + :Cl -of 1 . 18 :1 does not cause hyperchloraemia and Na excretion following infusion is more rapid. Salt and water overload causes not only peripheral and pulmonary oedema, but may also produce splanchnic oedema, resulting in ileus or acute intestinal failure. This overload may sometimes be an inevitable consequence of resuscitation, yet it may take 3 weeks to excrete this excess. It is important to avoid unnecessary additional overload by not prescribing excessive maintenance fluids after the need for resuscitation has passed. Most patients require 2-2 . 5 litres water and 60-100 mmol Na/d for maintenance in order to prevent a positive fluid balance. This requirement must not be confused with those for resuscitation of the hypovolaemic patient in whom the main aim of fluid therapy is repletion of the intravascular volume. Fluid and electrolyte balance is a vital component of the metabolic care of surgical and critically-ill patients, with important consequences for gastrointestinal function and hence nutrition. It is also of importance when prescribing artificial nutrition and should be given the same careful consideration as other nutritional and pharmacological needs.

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“…Eligibility and intervention were as for the original study. 1 Only patients who received bowel preparation and proceeded to surgery were included in this study (Fig. 1).…”

Section: Eligibility Inclusion and Interventionmentioning

confidence: 99%

“…We have previously shown that Picolax bowel preparation causes a significant dehydrating effect that can be minimised by administering a calculated volume of intravenous fluid; 1 however, that study was only designed to analyse data up until the time of surgery.…”

mentioning

confidence: 99%

Is Patient Outcome Affected by the Administration of Intravenous Fluid During Bowel Preparation for Colonic Surgery?

Sanders

Arthur

Hosie

et al. 2007

annals

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INTRODUCTION We have previously shown that Picolax ® bowel preparation causes a significant dehydrating effect, which can be minimised by administering a calculated volume of intravenous fluid. The aim of this prospective study was to assess whether peri-operative outcome is affected by administering a calculated volume of intravenous fluid during bowel preparation.PATIENTS AND METHODS Patients having bowel preparation (Picolax ®

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Randomized clinical trial of intravenous fluid replacement during bowel preparation for surgery

Abstract: Picolax bowel preparation has a significant dehydrating effect, which can be minimized by administering a simultaneous volume of intravenous fluid (mean 2 litres in this study).

Cited by 86 publications

References 5 publications

Hyperphosphatemia after sodium phosphate laxatives inlow risk patients: Prospective study

Hyperphosphatemia after sodium phosphate laxatives inlow risk patients: Prospective study

Fluid, electrolytes and nutrition: physiological and clinical aspects

Is Patient Outcome Affected by the Administration of Intravenous Fluid During Bowel Preparation for Colonic Surgery?

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