Erratum to: Monitoring intracellular, interstitial, and intravascular volume changes during fluid management procedures

Abstract This paper describes a new combined impedance plethysmographic (IPG) and electrical bioimpedance spectroscopic (BIS) instrument and software that will allow noninvasive real-time measurement of segmental blood flow, intracellular, interstitial, and intravascular volume changes during various fluid management procedures. The impedance device can be operated either as a fixed frequency IPG for the quantification of segmental blood flow and hemodynamics or as a multi-frequency BIS for the recording of intracellular and extracellular resistances at 40 discrete input frequencies. The extracellular volume is then deconvoluted to obtain its intravascular and interstitial component volumes as functions of elapsed time. The purpose of this paper is to describe this instrumentation and to demonstrate the information that can be obtained by using it to monitor segmental compartment volume responses of a pig model during simulated hemorrhage and resuscitation. Such information may prove valuable in the diagnosis and management of rapid changes in the body fluid balance and various clinical treatments.

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Radionuclide assessment of peripheral intravascular capacity: a technique to measure intravascular volume changes in the capacitance circulation in man.

Circulation ◽

10.1161/01.cir.64.1.146 ◽

1981 ◽

Vol 64 (1) ◽

pp. 146-152 ◽

Cited By ~ 107

Author(s):

D L Rutlen ◽

F J Wackers ◽

B L Zaret

Keyword(s):

Intravascular Volume ◽

Volume Changes

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Abstract 10257: Vascular Expansion During Worsening of Heart Failure: Effects on Clinical Features and Its Determinants

Circulation ◽

10.1161/circ.132.suppl_3.10257 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Hajime Kataoka

Keyword(s):

Heart Failure ◽

Renal Function ◽

Clinical Features ◽

Lower Incidence ◽

Intravascular Volume ◽

Volume Changes ◽

Blood Tests ◽

Independent Association ◽

Leg Edema ◽

Relative Change

Introduction: During worsening heart failure (HF), it is unknown whether clinical features differ according to the level of vascular expansion, and how changes in serum substance(s) are associated with volume changes. Hypothesis: Changes in serum solutes/albumin are associated with vascular expansion and induce different clinical features during HF worsening. Methods: Data from 47 HF patients that experienced a worsening HF episode were analyzed. Each patient had at least 2 of the following HF signs: S3, rales, leg edema, body weight (BW) gain (≥1.5 kg), and ultrasound pleural effusion. Blood tests included hemoglobin (Hb), hematocrit (Ht), albumin, solutes [sodium (Na), potassium, chlorine (Cl), blood urea nitrogen, creatinine (Cr), and uric acid], and b-type natriuretic peptide (BNP). The relative change in the vascular expansion from stable to worsening HF was estimated based on changes in the plasma volume (%PV) as follows: 100 x {Hb (stable) x [1-Ht (worse)]}/ {Hb (worse) x [1-Ht (stable)]}-100. Results: When divided into two groups by the median %PV, the clinical features of the expansion group [11≤%PV (range 11 to 36%); n=24] had a lower incidence of rales (13 vs 52%, p=0.005) and a tendency toward preserved renal function defined by a decrease in serum Cr (83 vs 57%, p=0.06) as compared with the non-expansion group [%PV (range -19 to 10.8%)<11;n= 23], though the increase in BW and log BNP did not differ between groups. The expansion group had a greater increase in serum Na (3.58±4.43 vs -0.11±3.31mEq, p=0.0016) and Cl (5.54±6.24 vs -0.03±4.18, p=0.0006), and a greater decrease in albumin (-0.37±0.3 vs -0.16±0.3, p=0.04) from stability to worsening HF. Logistic regression analysis revealed an independent association between the increase in %PV and the increase in the serum Cl concentration from stability to HF worsening (OR:12.5, 95%CI: 1.89-82, P=0.009). Conclusions: Vascular expansion during worsening HF is associated with changes in the serum Cl concentration. As a key osmolyte, greater accumulation of this solute in the blood vessels might act to increase or maintain intravascular volume, which induces different clinical features of HF, such as a lower incidence of rales and preserved renal function due to maintenance of the blood supply to the kidney.

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Influence of splanchnic intravascular volume changes on cardiac output during muscarinic receptor stimulation in the anaesthetized dog

Acta Physiologica Scandinavica ◽

10.1111/j.1748-1716.1990.tb08854.x ◽

1990 ◽

Vol 138 (3) ◽

pp. 331-336 ◽

Cited By ~ 4

Author(s):

M. A. MORSE ◽

L. BELL ◽

D. L. RUTLEN

Keyword(s):

Cardiac Output ◽

Muscarinic Receptor ◽

Intravascular Volume ◽

Volume Changes ◽

Receptor Stimulation ◽

Anaesthetized Dog

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Perioperative Intravascular Fluid Assessment and Monitoring: A Narrative Review of Established and Emerging Techniques

Anesthesiology Research and Practice ◽

10.1155/2011/231493 ◽

2011 ◽

Vol 2011 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Sumit Singh ◽

Ware G. Kuschner ◽

Geoffrey Lighthall

Keyword(s):

Perioperative Care ◽

Fluid Overload ◽

Fluid Management ◽

Critically Ill Patient ◽

Intravascular Volume ◽

Unstable Patient ◽

Fluid Status ◽

Assessment And Monitoring ◽

Invasive Techniques ◽

Intravascular Volume Status

Accurate assessments of intravascular fluid status are an essential part of perioperative care and necessary in the management of the hemodynamically unstable patient. Goal-directed fluid management can facilitate resuscitation of the hypovolemic patient, reduce the risk of fluid overload, reduce the risk of the injudicious use of vasopressors and inotropes, and improve clinical outcomes. In this paper, we discuss the strengths and limitations of a spectrum of noninvasive and invasive techniques for assessing and monitoring intravascular volume status and fluid responsiveness in the perioperative and critically ill patient.

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Electrolyte regulation during the adaptation of humans to life at high altitude

Proceedings of the Royal Society of London Series B Biological Sciences ◽

10.1098/rspb.1966.0068 ◽

1966 ◽

Vol 165 (999) ◽

pp. 266-280 ◽

Cited By ~ 12

Keyword(s):

High Altitude ◽

Complete Recovery ◽

Potassium Content ◽

Published Data ◽

Intravascular Volume ◽

Volume Changes ◽

Aldosterone Level ◽

Significant Volume ◽

Low Levels ◽

Sodium And Potassium

Studies related to the body’s regulation of its sodium and potassium content have been made on a number of occasions during periods spent at high altitude. It is shown that on ascent from usual levels of residence the ratio of sodium to potassium in the saliva tends to rise above normal and later to fall with continued residence at altitude. The implications of this finding have been confirmed by subsidiary studies. The urinary aldosterone excreted while resident at altitude has been assayed and it has been shown to fall to very low levels. In contrast to what occurs with 17-hydroxycorticosteroids there appears to be a delay in the fall of urinary aldosterone although this has still to be confirmed by further studies which are in course of preparation. With continued residence at high altitude the urinary aldosterone level recovers but complete recovery takes several weeks. Published data are reviewed and it is concluded that these results are due to the changes in intravascular volume which occur on ascent to an environment of reduced p 0 2 . It is probable that the significant volume changes are intrathoracic.

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A system to monitor segmental intracellular, interstitial, and intravascular volume and circulatory changes during acute hemodialysis

Journal of Electrical Bioimpedance ◽

10.5617/jeb.4443 ◽

2019 ◽

Vol 8 (1) ◽

pp. 40-53 ◽

Cited By ~ 1

Author(s):

Leslie D. Montgomery ◽

Richard W. Montgomery ◽

Wayne A. Gerth ◽

Marty Loughry ◽

Susie Q. Lew ◽

...

Keyword(s):

Blood Flow ◽

Fluid Management ◽

Extracellular Volume ◽

The Body ◽

Real Time Measurement ◽

Management Procedures ◽

Electrical Bioimpedance ◽

Stage Renal Disease ◽

End Stage ◽

Body Fluid Balance

Abstract This paper describes a new combined impedance plethysmographic (IPG) and electrical bioimpedance spectroscopic (BIS) instrument and software that allows noninvasive real-time measurement of segmental blood flow and changes in intracellular, interstitial, and intravascular volumes during various fluid management procedures. The impedance device can be operated either as a fixed frequency IPG for the quantification of segmental blood flow and hemodynamics or as a multi-frequency BIS for the recording of intracellular and extracellular resistances at 40 discrete input frequencies. The extracellular volume is then deconvoluted to obtain its intra-vascular and interstitial component volumes as functions of elapsed time. The purpose of this paper is to describe this instrumentation and to demonstrate the information that can be obtained by using it to monitor segmental compartment volumes and circulatory responses of end stage renal disease patients during acute hemodialysis. Such information may prove valuable in the diagnosis and management of rapid changes in the body fluid balance and various clinical treatments.

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Quantitative radionuclide assessment of total pulmonary vascular volume changes

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y90-110 ◽

1990 ◽

Vol 68 (6) ◽

pp. 727-732 ◽

Cited By ~ 8

Author(s):

Leonard Bell ◽

David L. Rutlen

Keyword(s):

Pulmonary Artery ◽

Radionuclide Imaging ◽

Pulmonary Circulation ◽

Intravascular Volume ◽

Volume Changes ◽

Vascular Volume ◽

Reservoir Volume ◽

Constant Rate ◽

Quantitative Radionuclide Imaging ◽

Artery Flow

Current techniques do not permit continuous and noninvasive assessments of changes in total pulmonary intravascular volume. Hence, the present study was undertaken to determine whether quantitative radionuclide imaging can be used to determine the direction and estimate the magnitude of total pulmonary vascular volume changes. The pulmonary circulation was separately perfused at a constant rate via the pulmonary artery and drained at a constant pressure via the left atrium in nine dogs. Changes in pulmonary intravascular volume were recorded as reciprocal changes in extracorporeal reservoir volume during phenylephrine or isoproterenol administration, a 20% increase in pulmonary artery flow or a 5 mmHg (1 mmHg = 133.32 Pa) decrease in left atrial pressure. Erythrocytes were labeled with technetium-99 m and pulmonary volume changes were determined from tissue attenuation, blood radioactivity, and changes in total pulmonary radioactivity obtained with a γ-camera. During each of the interventions, count changes correlated with volume changes (r ≥ 0.75). The technique reliably detected volume changes as small as 10 mL. For all 531 individual pairs of radionuclide- and reservoir-determined volume changes, the correlation between reservoir-determined and radionuclide-estimated pulmonary intravascular volume changes was 0.87. The standard error of the radionuclide estimate was 21 mL. Hence, the present study demonstrates that quantitative radionuclide imaging can be used to continuously and noninvasively determine total pulmonary vascular volume changes.Key words: pulmonary circulation, intravascular volume, radionuclide imaging, capacitance vasculature.

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Anesthetic Management of Patients Undergoing Renal Transplantation: A Review of A Two-year Experience

10.22514/sv.2020.16.0078 ◽

2020 ◽

Keyword(s):

Renal Transplantation ◽

Perioperative Complications ◽

Anesthetic Management ◽

Fluid Management ◽

Graft Function ◽

University Hospital ◽

Ischemic Time ◽

Cold Ischemic Time ◽

Management Procedures ◽

Duration Of Surgery

Objectives: This study reviewed the anesthetic management procedures used for renal transplantation patients at a university hospital in Turkey over a two-year period. Areas of interest included preoperative status, fluid management, perioperative complications, and postoperative analgesia. Methods: A retrospective review of hospital records and information collected from all patients undergoing renal transplantation, performed at Ondokuz Mayıs University Hospital from 2018 to 2020, was conducted. Results: A total of 90 renal transplants were performed during the study time period. Of the patients undergoing renal transplantation, 44.4% were female and 55.6% were male. 52 patients were recipients of cadaveric transplants and 38 patients received kidneys from living, related donors. The duration of surgery and cold ischemic time were longer in the recipients of the cadaveric transplants (p < 0.05). Delayed graft function was statistically significantly higher in the kidney transplants obtained from the cadaveric donors than the living donors (p < 0.05). Conclusions: This study showed that anesthesia for renal transplantation is a safe and effective method if a selected range of drugs and techniques is used. Applying a well-planned standard anesthesia protocol and updating it periodically in line with the current literature will contribute to improving the quality of the outcomes renal transplantation surgery.

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