| Arteriovenous differences in plasma dilution and the distribution kinetics of lactated ringer's solution. | |
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MedLine Citation:
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PMID: 19095840 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Conventional concept suggests that infused crystalloid fluid is first distributed in the plasma volume and then, since the capillary permeability for fluid is very high, almost instantly equilibrates with the extracellular fluid space. We challenge whether this view is consistent with findings based on volume kinetic analysis. METHODS: Fifteen volunteers received an IV infusion of 15 mL/kg of lactated Ringer's solution during 10 min. Simultaneous arterial and venous blood hemoglobin (Hgb) samples were obtained and Hgb concentrations measured. The arteriovenous (AV) difference in Hgb dilution in the forearm was determined and a volume kinetic model was fitted to the series of Hgb concentrations in arterial and venous blood. RESULTS: The AV difference in plasma dilution was only positive during the infusion and for 2.5 min thereafter, which represents the period of net flow of fluid from plasma to tissue. Kinetic analysis showed that volume expansion of the peripheral fluid space began to decrease 14 min (arterial blood) and 20 min (venous blood) after the infusion ended. Distribution of lactated Ringer's solution apparently occurs much faster in the forearm than in the body as a whole. Therefore, the AV difference in the arm does not accurately reflect the distribution of Ringer's solutions or whole-body changes in plasma volume. CONCLUSIONS: The relatively slow whole-body distribution of lactated Ringer's solution, which boosts the plasma volume expansion during and for up to 30 min after an infusion, is probably governed by a joint effect of capillary permeability and differences in tissue perfusion between body regions. |
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Authors:
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Christer H Svensen; Peter M Rodhe; Joel Olsson; Elisabet Børsheim; Asle Aarsland; Robert G Hahn |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 108 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-19 Completed Date: 2009-01-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 128-33 Citation Subset: AIM; IM |
Affiliation:
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Clinical Research Center, Södertalje Hospital, Södertalje, Sweden. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Capillary Permeability Extracellular Fluid / metabolism Female Forearm / blood supply* Hemodilution* Hemoglobins / metabolism Humans Infusions, Intravenous Isotonic Solutions / administration & dosage, pharmacokinetics* Male Models, Biological Plasma Volume Radial Artery / metabolism Tissue Distribution Veins / metabolism Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR 00073/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins; 0/Isotonic Solutions; 8022-63-7/Ringer's lactate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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