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Intra‐operative colloid administration increases the clearance of a post‐operative fluid load
Author(s) -
BORUP T.,
HAHN R. G.,
HOLTE K.,
RAVN L.,
KEHLET H.
Publication year - 2009
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2008.01857.x
Subject(s) - medicine , plasma clearance , clearance rate , anesthesia , pharmacokinetics , excretion , cholecystectomy , plasma concentration , laparoscopic cholecystectomy , plasma volume , urology , surgery
Background: It is unknown whether an intra‐operative colloid infusion alters the dynamics of a crystalloid load administered post‐operatively. Methods: Ten patients received 12.5 ml/kg of Ringer's lactate over 30 min 1–3 days before and 4 h after laparoscopic cholecystectomy, during which 10 ml/kg of a colloid solution, hydroxyethylstarch (HES 130/0.4), was infused. The total body clearance of the pre‐ and post‐operative test infusions was taken as the ratio between the urinary excretion and the Hb‐derived dilution of venous plasma over 150 min. The plasma clearance of the infused fluid was calculated using volume kinetics based on the plasma dilution alone. The pre‐operative plasma clearance was compared with the post‐operative plasma clearance and patients served as their own control. Results: The urinary excretion averaged 350 ml for the pre‐operative infusion and 612 ml post‐operatively, which corresponds to 46% and 68% of the pre‐ and post‐operative infusions, respectively. The total body clearance of the crystalloid fluid was 30 ml/min before surgery and 124 ml/min after surgery ( P <0.01). The plasma clearance, as obtained from the plasma dilution alone, was 28 and 412 ml/min, respectively. The maximal increase in plasma volume was 410 ml pre‐operatively vs. 220 ml post‐operatively. Conclusions: Infusion of a colloid solution in combination with a crystalloid during laparoscopic cholecystectomy increased the plasma clearance of a post‐operative crystalloid infusion.