Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.

Fluid disorders always accompany acute pathology of abdominal organs. To conduct comparative analysis of efficiency of the goal-directed and restrictive regimens of infusion therapy of replenishment of volume depletion in high surgical risk patients with acute abdominal pathology 80 patients, operat...

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Main Author: O. V. Kravets
Format: Article
Language:English
Published: Dnipro State Medical University 2019-11-01
Series:Medičnì Perspektivi
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Online Access:http://journals.uran.ua/index.php/2307-0404/article/view/181877
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author O. V. Kravets
author_facet O. V. Kravets
author_sort O. V. Kravets
collection DOAJ
description Fluid disorders always accompany acute pathology of abdominal organs. To conduct comparative analysis of efficiency of the goal-directed and restrictive regimens of infusion therapy of replenishment of volume depletion in high surgical risk patients with acute abdominal pathology 80 patients, operated by urgent laparotomy were studied. Patients were divided into two groups. In the first group (n=40) a goal-directed infusion therapy was conducted, in the second (n=40) – restrictive. Rheographic method was used to investigate the performance of water sectors of the organism, daily and cumulative water balances were defined, the percentage of excessive fluid was determined and estimated. In patients of the first group an increase in plasma volume by 11% (p<0.05), exceeding of the volume of interstitium by 14% (p<0.05) and the volume of extracellular fluid by 7% (p<0.05) on the 1st and 2nd day were noted. From the 3 to 7th day a reduction in extracellular fluid to 91.5% (p<0.05) of the norm was noted. Recovery of all the studied parameters was detected on the 10th postoperative day, when the percent of excessive fluid reached 9.6%. In patients of the second group there was restoration of plasma volume to normal in reduced by 10% (p<0.05) – 12% (p<0.05) from the norm of the interstitium volume, respectively to the 1st and 2nd day after surgery. From the 3d day there was a significant restoration to normal of all the studied parameters, which coincided with the “zero” values of the daily water balance and sufe limits of the percent of excess fluid, which reached 6.1% on the 10th day of treatment. Thus, the goal-directed infusion therapy allows to perform the correction of volume depletion in high surgical risk patients with acute abdominal pathology by increasing intravascular volume to excessive and increase of interstitium volume on 1st and 2nd day, development of a mild volume depletion from the 3d to 5th day, maintainance of the percentage of excessive fluids within safe borders. Restrictive mode of infusion therapy normalizes fluid balance of water sectors due to restoration of plasma volume in 6 hours of treatment and maintains it within the limits of the norm during all the postoperative period, preventis the development of interstitial oedema, ensures the "zero" daily water balance and limits the postoperative growth of the percentage of excess fluid.
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spelling doaj-art-659ab9d47c044a809633d3836c2d796c2024-12-02T03:03:54ZengDnipro State Medical UniversityMedičnì Perspektivi2307-04042019-11-01243394510.26641/2307-0404.2019.3.181877181877Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.O. V. KravetsFluid disorders always accompany acute pathology of abdominal organs. To conduct comparative analysis of efficiency of the goal-directed and restrictive regimens of infusion therapy of replenishment of volume depletion in high surgical risk patients with acute abdominal pathology 80 patients, operated by urgent laparotomy were studied. Patients were divided into two groups. In the first group (n=40) a goal-directed infusion therapy was conducted, in the second (n=40) – restrictive. Rheographic method was used to investigate the performance of water sectors of the organism, daily and cumulative water balances were defined, the percentage of excessive fluid was determined and estimated. In patients of the first group an increase in plasma volume by 11% (p<0.05), exceeding of the volume of interstitium by 14% (p<0.05) and the volume of extracellular fluid by 7% (p<0.05) on the 1st and 2nd day were noted. From the 3 to 7th day a reduction in extracellular fluid to 91.5% (p<0.05) of the norm was noted. Recovery of all the studied parameters was detected on the 10th postoperative day, when the percent of excessive fluid reached 9.6%. In patients of the second group there was restoration of plasma volume to normal in reduced by 10% (p<0.05) – 12% (p<0.05) from the norm of the interstitium volume, respectively to the 1st and 2nd day after surgery. From the 3d day there was a significant restoration to normal of all the studied parameters, which coincided with the “zero” values of the daily water balance and sufe limits of the percent of excess fluid, which reached 6.1% on the 10th day of treatment. Thus, the goal-directed infusion therapy allows to perform the correction of volume depletion in high surgical risk patients with acute abdominal pathology by increasing intravascular volume to excessive and increase of interstitium volume on 1st and 2nd day, development of a mild volume depletion from the 3d to 5th day, maintainance of the percentage of excessive fluids within safe borders. Restrictive mode of infusion therapy normalizes fluid balance of water sectors due to restoration of plasma volume in 6 hours of treatment and maintains it within the limits of the norm during all the postoperative period, preventis the development of interstitial oedema, ensures the "zero" daily water balance and limits the postoperative growth of the percentage of excess fluid.http://journals.uran.ua/index.php/2307-0404/article/view/181877goal-directed regimenrestrictive regimeninfusion therapywater balanceacute abdominal pathologyhigh surgical risk
spellingShingle O. V. Kravets
Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.
Medičnì Perspektivi
goal-directed regimen
restrictive regimen
infusion therapy
water balance
acute abdominal pathology
high surgical risk
title Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.
title_full Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.
title_fullStr Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.
title_full_unstemmed Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.
title_short Assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology.
title_sort assessment of fluid balance in different regimens of infusion therapy of high surgical risk patients with acute abdominal pathology
topic goal-directed regimen
restrictive regimen
infusion therapy
water balance
acute abdominal pathology
high surgical risk
url http://journals.uran.ua/index.php/2307-0404/article/view/181877
work_keys_str_mv AT ovkravets assessmentoffluidbalanceindifferentregimensofinfusiontherapyofhighsurgicalriskpatientswithacuteabdominalpathology