Distribution of crystalloid fluid changes with the rate of infusion: a population-based study

Acta Anaesthesiologica Scandinavica
R G HahnJ Zdolsek

Abstract

Crystalloid fluid requires 30 min for complete distribution throughout the extracellular fluid space and tends to cause long-standing peripheral edema. A kinetic analysis of the distribution of Ringer's acetate with increasing infusion rates was performed to obtain a better understanding of these characteristics of crystalloids. Data were retrieved from six studies in which 76 volunteers and preoperative patients had received between 300 ml and 2375 ml of Ringer's acetate solution at a rate of 20-80 ml/min (0.33-0.83 ml/min/kg). Serial measurements of the blood hemoglobin concentration were used as inputs in a kinetic analysis based on a two-volume model with micro-constants, using software for nonlinear mixed effects. The micro-constants describing distribution (k12) and elimination (k10) were unchanged when the rate of infusion increased, with half-times of 16 and 26 min, respectively. In contrast, the micro-constant describing how rapidly the already distributed fluid left the peripheral space (k21) decreased by 90% when the fluid was infused more rapidly, corresponding to an increase in the half-time from 3 to 30 min. The central volume of distribution (V(c)) doubled. The return of Ringer's acetate from the peripheral fluid...Continue Reading

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Citations

Apr 30, 2017·Anesthesia and Analgesia·Robert G Hahn
Feb 14, 2019·British Journal of Clinical Pharmacology·Robert G HahnHåkan Björne
Dec 22, 2019·Acta Anaesthesiologica Scandinavica·Robert G Hahn
Apr 9, 2016·European Journal of Anaesthesiology·Robert G Hahn, Gordon Lyons
Dec 5, 2019·Acute and Critical Care·Dongho Kang, Kyung Yeon Yoo
May 6, 2020·Critical Care : the Official Journal of the Critical Care Forum·Markus ZdolsekJoachim H Zdolsek
Apr 9, 2020·European Journal of Anaesthesiology·Robert G Hahn
Apr 5, 2018·Frontiers in Veterinary Science·Jessica Noel-Morgan, William W Muir
Dec 11, 2019·Scientific Reports·Jung-Min YiGyu-Jeong Noh
Nov 12, 2020·Acta Anaesthesiologica Scandinavica·Robert G Hahn
Dec 18, 2020·Frontiers in Veterinary Science·Xiu Ting YiewWilliam W Muir
Mar 6, 2021·Korean journal of anesthesiology·Byung-Moon Choi

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