Reliability of Clinical Assessment of Fluid Absorption in Transurethral Prostatic Resection

Olsson, Joel; Rentzhog, L; Hjertberg, Hans; Rg, Hahn

doi:10.1159/000474306

Cited by 24 publications

(14 citation statements)

References 7 publications

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“…It should be noted that about 10% of the absorption events are followed by a slow, but sustained, increase in the breath ethanol level [6,15,17] which is consistent with a release of ethanol from a pool deposited in the body following an instrumental perforation. The symptoms of extravasation (abdominal pain, hypotension) are slightly different from those seen when fluid enters the blood directly [ 15], and the relationships between AUC and the volume of irrigant absorbed shown in the present study are not applicable.…”

Section: Discussionsupporting

confidence: 55%

“…The most important thing, however, is that the urologist may halt or modify the operation before enough fluid is absorbed to elicit overt symptoms [6], This should be done when absorption is no more than between 1 and 2 litres, as patients in this absorption range have a seven-fold higher risk of developing mild symp toms of the transurethral resection syndrome during the early postoperative period [15]. An absorption of this magnitude occurs in 5-10% of the operations [16][17][18], Severe syndromes are rare nowadays [19], but those who use ethanol monitoring as recommended eliminate the need for any patient to stay in the intensive care unit over night because of a massive fluid overload.…”

Section: Discussionmentioning

confidence: 99%

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Estimation of Fluid Absorption by Using the Area under the Curve for Ethanol in Expired Air

Hahn¹

1997

Urol Int

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The use of irrigating fluid containing a small amount of ethanol allows fluid absorption to be monitored by means of expired-breath tests during transurethral resection of the prostate (TURP). There is, however, no consensus concerning how the breath ethanol data should be converted into the volume of irrigant absorbed. The present study examines the use of the product of concentration and time (area under the curve) to predict how much fluid is absorbed. Intermittent infusions of ethanol in 5 volunteers showed that the relationship between area under the curve and ethanol load was best described by a polynomial expression. This was also applicable to the uptake of small volumes of irrigating fluid during 16 TURPs. When patients with large-sized absorption ( > 1,000 ml) were also considered, however, the precision was better when the absorbed volume was predicted by a multiple linear regression formula where the ethanol level in the exhaled breath at the end of any 10-min period during TURP and the time during which ethanol had been detected served as independent factors.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Estimation of Fluid Absorption by Using the Area under the Curve for Ethanol in Expired Air

Hahn¹

1997

Urol Int

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“…Measurements of the plasma level of lactate dehydrogenase in volunteers given 1% glycine+ethanol negligible and an apparent risk of symptoms developing [2, 8,11]. Absorption in excess of this amount by intravenous infusion indicated that haemolysis does not occur in vivo [4] but 1% glycine+ethanol still offers usually occurs in 5-8% of the patients undergoing TURP [12][13][14]; in the present study, the incidence a smaller safety margin before haemolysis occurs than does 1.5% glycine.…”

Section: Factors Correlating With Symptomsmentioning

confidence: 63%

Glycine 1.0%versus glycine 1.5% as irrigating fluid during transurethral resection of the prostate

Hahn

Shemais

Essén

1997

British Journal of Urology

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Objective To evaluate the potential benefits of reducing to haemolyse. Reducing the glycine concentration did not alter the optical conditions during TURP. The the glycine concentration from 1.5% to 1.0% in the irrigating fluid used during transurethral resection of incidence of symptoms increased significantly as more glycine solution was absorbed, arterial hypotension the prostate (TURP) when 1% ethanol is used as the tracer of absorption.and nausea being the most usual. Bradycardia, prickling skin sensations and feelings of uneasiness were Patients and methods The effect of 1% ethanol on the tendency for blood to haemolyse was tested in vitro less common when 1.0% glycine was used, but the choice of irrigating fluid had no effect on the total and the optical condition of the irrigating fluids were studied during 10 TURPs. The breath ethanol level incidence of symptoms. Conclusion We found no clear advantage in lowering was monitored during 423 operations where these fluids were used in a randomized double-blind study.the glycine concentration of the irrigating fluid used during TURP. The incidence of 13 symptoms was recorded in the 77 patients who absorbed irrigating fluid.

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“…reduced natremia, increased glycinemic concentration and sometimes reduced osmolality. Although natremia and osmolality levels can generally be determined rapidly during surgery, glycinemia values are only available afterwards because of laboratory times, and so cannot be used for early diagnosis of fluid absorption [10,30,31].…”

Section: Preventionmentioning

confidence: 99%

“…The most commonly used instrument for measuring breath ethanol content is the Alcolmeter SD-2. More and more reports recommend routine ethanol and expired breath (EB) ethanol marking in irrigation solutions for the early diagnosis of TURP-S [31][32][33][34].…”

Section: Preventionmentioning

confidence: 99%

The Pathophysiology, Diagnosis and Therapy of the Transurethral Resection of the Prostate Syndrome

Ficarra¹,

Bartoloni²,

Tallarigo³

et al. 2001

Urol Int

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Reliability of Clinical Assessment of Fluid Absorption in Transurethral Prostatic Resection

Cited by 24 publications

References 7 publications

Estimation of Fluid Absorption by Using the Area under the Curve for Ethanol in Expired Air

Estimation of Fluid Absorption by Using the Area under the Curve for Ethanol in Expired Air

Glycine 1.0%versus glycine 1.5% as irrigating fluid during transurethral resection of the prostate

The Pathophysiology, Diagnosis and Therapy of the Transurethral Resection of the Prostate Syndrome

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