Perioperative dynamics of water sectors at restrictive regime of infusion therapy in high surgical risk patients with acute abdominal pathology

August 29, 2019
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The aim is to evaluate the effectiveness of the restrictive regime of infusion therapy in high surgical risk patients with acute abdominal pathology on the basis of the analysis of perioperative dynamics of water sectors of the body. Material and methods. 30 patients of high surgical risk with acute abdominal pathology were examined, who were operated upon surgically in the volume of laparatomy. Surgical infusion therapy was performed in restrictive mode. Indicators of body water sectors were determined by the method of noninvasive bioelectric rheography. Results. The restoration of plasma volume to the norm and the deficit of interstitial volume in 20.7% (p<0.05) in 6 hours from the start of treatment was noted. Full restoration and preservation of plasma volume within the normal limits, increase in the volume of interstititium by 9.8% (p<0.05) in comparison with the initial one, decrease in the degree of volume exhaustion to a mild one — 8.6% (p<0.05) were established in 1 day. Intracellular volume sector did not differ significantly from the norm and previous stages of observation. From 1 to 14 days observed normal values of the studied parameters. Conclusions. Restrictive infusion therapy regime in patients with high surgical risk with acute abdominal pathology allows to carry out effective correction of volume exhaustion by restoration of intravascular volume in 6 hours from the beginning of treatment, elimination of the deficit of interstitial volume and restoration of the total volume of liquid by 3 days.

Published: 29.08.2019
References:

  • Bereznytskiy Ya.S., Boiko V.V., Brusnitsyna M.P. et al. (2010) Standards of organization and professionally oriented protocols of emergency care for patients with surgical abdominal pathology (departmental instruction). Dnipro, 256 р.
  • Boland M.R., Noorani A., Varty K. et al. (2013) Perioperative fluid restriction in major abdominal surgery: systematic review and meta-analysis of randomized, clinical trials. World J. Surg., 37(6): 1193–1202.
  • Carlisle J.B. (2019) Risk prediction models for major surgery: composing a new tune. Anaesthesia, 74: 7–12.
  • Hoste E.A., Maitland K., Brudney C.S. et al.; ADQI XII Investigators Group (2014) Four phases of intravenous fluid therapy: a conceptual model. Br. J. Anaesth., 113(5): 740–747.
  • Kravets O.V., Klygunenko O.M., Sedinkin V.A. (2018) The method of perioperative infusion therapy in patients with urgent pathology of the abdominal cavity. Ukraine patent 128084.
  • NICE (2017) Intravenous fluid therapy in adults in hospital (https://www.nice.org.uk/guidance/cg174).
  • Royal College of Anaesthetists (2018) Fourth Patient NELA Audit Report Published (https://www.rcoa.ac.uk/news-and-bulletin/rcoa-news-and-statements/fourth-patient-nela-audit-report-published).
  • Vivekanand K.H., Mohankumar K., Dave P. et al. (2015) Clinical outcome of emergency laparotomy: our experience at tertiary care centre (a case series). Int. J. Biomed. Adv. Res., 6(10): 709–714.