Intercompartmental fluid volume shifts during cardiopulmonary bypass measured by A-mode ultrasonography

TY - JOUR

T1 - Intercompartmental fluid volume shifts during cardiopulmonary bypass measured by A-mode ultrasonography

AU - Schumacher, Jan

AU - Eichler, Wolfgang

AU - Heringlake, Matthias

AU - Sievers, Hans-Hinrich

AU - Klotz, Karl-Friedrich

PY - 2004

Y1 - 2004

N2 - To investigate the time course of fluid extravasation during cardiopulmonary bypass (CPB), we measured the peripheral tissue thickness (TT) by A-mode ultrasound in 34 patients undergoing elective cardiac surgery. TT of the forehead was determined by a handheld A-mode ultrasound device and 10 MHz Transducer at nine defined intervals, from the night before surgery until the first postoperative day. Mean calculated loss of 1700 +/- 40 mL (SEM) water during the fasting period resulted in a significant reduction of TT by 0.28 +/- 0.03 mm. From induction to start of CPB, rehydration with 1000 mL of fluid was performed and TT increased to baseline. After 60 min of extracorporal circulation, forehead TT increased significantly by 0.75 +/- 0.08 mm and remained unchanged until the end of surgery when the measured fluid gain was 1580 +/- 138 mL. At discharge from ICU, negative fluid regimen resulted in a balance of -127 +/- 146 mL whereas TT declined significantly to +0.16 +/- 0.09 mm compared to baseline. Dehydration due to fasting and the marked interstitial fluid extravasation during CPB could be detected by the changes of the peripheral TT. We conclude that parts of the fluid load during CPB are shifted from the intravascular compartment to the interstitial space in a time-dependent manner.

AB - To investigate the time course of fluid extravasation during cardiopulmonary bypass (CPB), we measured the peripheral tissue thickness (TT) by A-mode ultrasound in 34 patients undergoing elective cardiac surgery. TT of the forehead was determined by a handheld A-mode ultrasound device and 10 MHz Transducer at nine defined intervals, from the night before surgery until the first postoperative day. Mean calculated loss of 1700 +/- 40 mL (SEM) water during the fasting period resulted in a significant reduction of TT by 0.28 +/- 0.03 mm. From induction to start of CPB, rehydration with 1000 mL of fluid was performed and TT increased to baseline. After 60 min of extracorporal circulation, forehead TT increased significantly by 0.75 +/- 0.08 mm and remained unchanged until the end of surgery when the measured fluid gain was 1580 +/- 138 mL. At discharge from ICU, negative fluid regimen resulted in a balance of -127 +/- 146 mL whereas TT declined significantly to +0.16 +/- 0.09 mm compared to baseline. Dehydration due to fasting and the marked interstitial fluid extravasation during CPB could be detected by the changes of the peripheral TT. We conclude that parts of the fluid load during CPB are shifted from the intravascular compartment to the interstitial space in a time-dependent manner.

KW - Aged

KW - Body Fluids

KW - Cardiopulmonary Bypass

KW - Dehydration

KW - Fasting

KW - Female

KW - Fluid Therapy

KW - Forehead

KW - Humans

KW - Male

KW - Middle Aged

KW - Perioperative Care

KW - Ultrasonography

KW - Water-Electrolyte Balance

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1191/0267659104pf753oa

DO - 10.1191/0267659104pf753oa

M3 - Article

C2 - 15506031

SN - 0267-6591

VL - 19

SP - 277

EP - 281

JO - Perfusion

JF - Perfusion

IS - 5

ER -