Göz Mustafa, Sert Cemil, Hazar Abdussamet, Aydın Mehmet Salih, Kankılıç Nazim
Harran University Medical School Department of Cardiovascular Surgery Şanliurfa Turkey Department of Cardiovascular Surgery, Medical School of Harran University, Şanliurfa, Turkey.
Harran University Medical School Department of Biophysics Şanliurfa Turkey Department of Biophysics, Medical School of Harran University, Şanliurfa, Turkey.
Braz J Cardiovasc Surg. 2020 Feb 1;35(1):16-21. doi: 10.21470/1678-9741-2019-0152.
To evaluate preoperative and postoperative body fluid distribution with a bioelectrical impedance analyzer in patients undergoing cardiopulmonary bypass.
Fifteen adult patients undergoing cardiopulmonary bypass were included in this study. Total body fluid changes, basal metabolism rates, body fat masses, lean body masses, and total cell masses were recorded. The patients' values were measured before anesthesia, after anesthesia, after sternotomy, at the 5th, 30th, and 60th minutes of cardiopulmonary bypass, and on the 1st, 3rd, and 5th postoperative days. All values were compared with preoperative values.
Total body fluid changed significantly after cardiopulmonary bypass (P<0.01). Metabolic velocity significantly changed compared to preoperative measurements (P<0.05). Fat mass and lean body mass also changed significantly. Body mass index and phase angle did not change significantly (P>0.05).
Changes in body fluids during and after cardiopulmonary bypass are inevitable. The increase in total body weight shows that this fluid load shifts to the extracellular space during bypass and the fluid load in this area passes into the intravascular area in the early postoperative period. This may cause edema and dysfunction in the major organs. Therefore, the fluid balance should be adjusted very carefully, especially during the bypass phase and the early postoperative period.
使用生物电阻抗分析仪评估体外循环患者术前和术后的体液分布情况。
本研究纳入了15例接受体外循环的成年患者。记录总体液变化、基础代谢率、体脂质量、瘦体重和总细胞质量。在麻醉前、麻醉后、胸骨切开术后、体外循环第5、30和60分钟以及术后第1、3和5天测量患者的各项数值。所有数值均与术前数值进行比较。
体外循环后总体液发生显著变化（P<0.01）。与术前测量值相比，代谢速度发生显著变化（P<0.05）。脂肪质量和瘦体重也发生了显著变化。体重指数和相位角无显著变化（P>0.05）。
体外循环期间及之后体液变化不可避免。总体重增加表明，这种液体负荷在体外循环期间转移至细胞外间隙，且该区域的液体负荷在术后早期进入血管内区域。这可能导致主要器官出现水肿和功能障碍。因此，应非常谨慎地调整液体平衡，尤其是在体外循环阶段和术后早期。
