Department of Anaesthesiology and Critical Care Medicine, Medical University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria.
Sci Rep. 2017 Aug 29;7(1):9644. doi: 10.1038/s41598-017-09433-5.
The effects of intravenous fluid therapy on fluid compartments and hemodynamics of the human body remain enigmatic. We therefore tested the efficacy of bioimpedance spectroscopy in a crossover study, where 15 males received 0.5 ml/kg/min ELO-MEL-isoton (osmolarity = 302 mosmol/l) during 60 minutes, or nothing at all. In group "Fluid", fluid load increased from -0.2 ± 1.0 l extracellular volume at baseline to its maximum of 1.0 ± 0.9 l in minute 70, and remained continuously elevated throughout minute 300. In group "Zero", fluid load decreased from 0.5 ± 1.1 l at baseline to its minimum of -1.1 ± 1.1 l in minute 300. In group "Fluid", intracellular volume decreased from 26.8 ± 3.9 l at baseline to its minimum of 26.0 ± 3.9 l in minute 70, and remained continuously decreased throughout minute 300. In group "Zero", intracellular volume increased from 26.5 ± 3.8 l at baseline to its maximum of 27.1 ± 3.9 l in minute 120, and decreased thereafter. In group "Fluid" compared to "Zero", systolic blood pressure was significantly higher, from minute 50-90. In conclusion, intravenous fluid therapy caused a clinically meaningful, sustained increase in fluid load, and a decrease in intracellular volume. These data raise interest in studying fluid administration by the gastrointestinal route, perhaps even when managing critical illness.
静脉输液治疗对人体液体隔室和血流动力学的影响仍然是个谜。因此,我们在一项交叉研究中测试了生物阻抗谱的疗效,其中 15 名男性在 60 分钟内接受 0.5ml/kg/min 的 ELO-MEL-isoton(渗透压=302mosmol/l),或者根本不接受任何治疗。在“液体”组中,液体负荷从基线时的-0.2±1.0 升细胞外体积增加到第 70 分钟时的 1.0±0.9 升最大值,并在第 300 分钟持续升高。在“零液体”组中,液体负荷从基线时的 0.5±1.1 升减少到第 300 分钟时的最低值-1.1±1.1 升。在“液体”组中,细胞内体积从基线时的 26.8±3.9 升减少到第 70 分钟时的最低值 26.0±3.9 升,并在第 300 分钟持续减少。在“零液体”组中,细胞内体积从基线时的 26.5±3.8 升增加到第 120 分钟时的最大值 27.1±3.9 升,然后减少。与“零液体”组相比,“液体”组的收缩压从第 50 分钟到第 90 分钟显著升高。总之,静脉输液治疗导致液体负荷的临床意义上的持续增加,并减少细胞内体积。这些数据引起了人们对通过胃肠道途径给予液体的研究兴趣,甚至在治疗危重病时也是如此。