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Detection of dehydration by using volume kinetics.
- Source :
-
Anesthesia and analgesia [Anesth Analg] 2012 Oct; Vol. 115 (4), pp. 814-22. Date of Electronic Publication: 2012 Jul 04. - Publication Year :
- 2012
-
Abstract
- Background: Patients admitted to surgery may be dehydrated, which is difficult to diagnose except when it is severe (>5% Gl116 of the body weight). We hypothesized that modest dehydration can be detected by kinetic analysis of the blood hemoglobin concentration after a bolus infusion of crystalloid fluid.<br />Methods: Four series of experiments were performed on 10 conscious, healthy male volunteers. Separated by at least 2 days, they received 5 or 10 mL/kg acetated Ringer's solution over 15 minutes. Before starting half of the IV infusions, volume depletion amounting to 1.5 to 2.0 L (approximately 2% of body weight) was induced with furosemide. The elimination clearance and the half-life of the infused fluid were calculated based on blood hemoglobin over 120 minutes. The perfusion index and the pleth variability index were monitored by pulse oximetry after a change of body position.<br />Results: Dehydration decreased the elimination clearance of acetated Ringer's solution [median (25th-75th percentile)] from 1.84 (1.23-2.57) to 0.53 (0.41-0.79) mL/kg/min (Wilcoxon matched-pair test P < 0.001) and increased the half-life from 23 (12-37) to 76 (57-101) minutes (P < 0.001). The smaller infusion, 5 mL/kg, fully discriminated between experiments performed in the euhydrated and dehydrated states, whereas the urinary excretion provided a less-reliable indication of hydration status. Dehydration decreased the perfusion index but did not affect the pleth variability index.<br />Conclusion: Dehydration amounting to 2% of the body weight could be detected from the elimination clearance and the half-life of an infusion of 5 mL/kg Ringer's solution.
- Subjects :
- Adult
Blood Volume drug effects
Dehydration chemically induced
Diuretics administration & dosage
Diuretics pharmacokinetics
Furosemide administration & dosage
Furosemide pharmacokinetics
Humans
Isotonic Solutions administration & dosage
Male
Ringer's Solution
Young Adult
Blood Volume physiology
Dehydration blood
Dehydration diagnosis
Isotonic Solutions pharmacokinetics
Models, Biological
Subjects
Details
- Language :
- English
- ISSN :
- 1526-7598
- Volume :
- 115
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Anesthesia and analgesia
- Publication Type :
- Academic Journal
- Accession number :
- 22763905
- Full Text :
- https://doi.org/10.1213/ANE.0b013e318261f6ba