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At least 145 records · Page 8Linked to original sources
PubMed2000

The effects of synthetic and natural surfactant on fluid balance in acute respiratory distress syndrome.

UNLABELLED: To evaluate the effect of different surfactants on fluid balance in respiratory distress syndrome, we studied 24 premature infants who were randomised to receive either natural or synthetic surfactant. Data were collected on ventilatory parameters, daily urine output, daily weight, fluid intake and serum electrolytes. Ventilatory requirements decreased more rapidly in babies receiving natural surfactant, with significantly greater reductions in mean airway pressure from 1 to 48 h and oxygenation index from 1-18 h (P < 0.05). There were no differences in fluid intake and serum electrolytes. Mean daily urine output was higher in the group receiving natural surfactant (87 ml versus 61 ml, P < 0.05). This group also had a greater weight loss from birth weight (-146 g versus -65 g, P < 0.05). CONCLUSION: Natural surfactant produces an earlier reduction in ventilatory requirements with an earlier diuresis. This should influence fluid management in respiratory distress syndrome.

Biological Products↗
PubMed1984

Comparison of alpha- and gamma-thrombin on lung fluid balance in anesthetized sheep.

We examined the effects of varying dosages of thrombin on lung fluid balance in halothane-anesthetized sheep prepared with lung lymph fistulas. A 15-min iv infusion of sublethal doses of alpha-thrombin (2.5 clotting units/micrograms), the native enzyme, at 0.6 or 1.1 nmol active enzyme/kg body wt increased the mean pulmonary arterial pressure (Ppa) and pulmonary vascular resistance (PVR) two- to threefold. Neither parameter increased in a dose-dependent manner. Platelet counts decreased 50% with both dosages. Leukocyte counts decreased 35 and 75% from base line in the low- and high-dosage groups, respectively, and reached comparable levels of 50% below base line at 60-min postinfusion in both groups. Plasma fibrinogen concentrations decreased in a dose-dependent manner preceding dose-dependent increases in pulmonary lymph flow (Qlym) and lymph protein clearance (Clym). Fibrin deposition in pulmonary vessels was greater at 30 than at 180 min postinfusion. In contrast, a 15-min iv infusion of gamma-thrombin (0.002 clotting units/micrograms), which lacks the fibrinogen recognition site, at 1.2 nmol active enzyme/kg produced no significant increases in PVR, Ppa, Qlym, or Clym. The fibrinogen concentration did not change significantly, whereas platelet and leukocyte counts decreased 25% within 15 min. Fibrin microthrombi were less prominent in pulmonary vessels. Fibrin deposition associated with intravascular coagulation may be an important factor mediating thrombin-induced increases in pulmonary transvascular fluid and protein exchange.

6-Ketoprostaglandin F1 alpha↗
PubMed2002

The efficiency of fluid balance charting: an evidence-based management project.

This study began following an observation that fluid balance (FB) charts seemed to be overloading medical records in Hong Kong hospitals. The major issues for this study were the efficiency and appropriateness of FB charting. The study design included an analysis of 250 medical records and an opinion survey. Seventy-five doctors and 98 nurses participated in the survey. The results indicated that 50% of all medical records had FB charts and in these cases they made up between 12 and 16% of the whole medical record. Intravenous infusion and urinary catheterization accounted for almost 70% of the recorded reasons for using them. Thirty-two per cent of FB charts were found to be incomplete or inaccurate. Forty-six per cent of doctors and nurses reported that they believed that charts were not always terminated when they were not required. The most common belief among doctors was that only doctors should discontinue the FB charts. Nurses were almost unanimous in believing that they should not do this without the agreement of the doctors! It was concluded that nurses in the context under study should be empowered to terminate charts when they become unnecessary. In addition, the design of charts should be modified to accommodate different purposes.

Attitude of Health Personnel↗
PubMed1981

The effects of trienbolone acetate implantation of turkeys upon fluid balance and blood chemistry.

1. The effects of implanting turkeys with trienbolone acetate (TA) upon fluid balance and blood chemistry were studied. 2. The Na and water contents of skeletal muscles were increased by TA treatment while K was unaltered. 3. The extracellular space expressed as a proportion of starved body weight was unaffected by TA implantation. 4. Plasma or serum concentrations of P, Ca, Mg, Na and K and activities of the enzymes aspartate aminotransferase [EG 2.61.1], creatine kinase [EC 2.7.3.2] and gamma-glutamyl transferase [EC 2.3.2.2] were not changed by TA treatment. 5. Packed cell volume was significantly increased by TA implantation after a delay of some 2 to 3 weeks while plasma protein concentrations were immediately decreased for a period of two weeks before nearly normal concentrations were obtained again. 6. Erythrocyte sedimentation rate was decreased by TA treatment, but serum protein electrophoretic pattern was unchanged.

Anabolic Agents↗
PubMed1997

[Perioperative management of uremia and fluid balance in patients with compromised renal function undergoing open heart surgery].

Five patients with renal dysfunction underwent coronary artery bypass grafting (CABG). Three patients were in cardiogenic shock with acute myocardial infarction for whom CABG was carried out on emergent basis. Immediate preoperatively these patients were in almost anuria which was derived from sustained renal dysfunction plus decreased renal perfusion due to low cardiac output. The other two patients were operated on electively, and hemodynamic instability and artificial perfusion (cardiopulmonary bypass) affected their chronic renal disease (polycystic kidney and nephrosclerosis, respectively) so unfavorably that intraoperative anuria took place. In all patients intraoperative control of fluid balance and prevention of azotemia were accomplished by intraoperative hemofiltration (HF), in which 10 litters of body fluid was filtered out through a hemofiliter incorporated into the cardiopulmonary bypass circuit, and replaced with saline solution. In emergent cases (three patients) complete anuria was sustained and continuous hemodialysis/hemofilitration (CHDF) was successively performed to control water balance and to prevent exacerbation of uremia. Although they all were in profound low cardiac output state necessitating intraaortic balloon counterpulsation (IABP) and infusion of considerable amount of catecholamines, there was no hemodynamic instability occurred throughout the period of CHDF. In four cases renal function recovered significantly along with the recover from their cardiogenic shock so that they could wean from the hemodialysis therapy. In the remaining case intermittent hemodialysis was necessary in chronic phase. There were no hospital death nor late mortality. From this experience we might conclude that the combined use of intraoperative HF and successive postoperative CHDF is an effective method for controlling fluid balance and preventing uremia in cardiac surgical patients with severe renal dysfunction along with considerable hemodynamic instability.

Aged↗
PubMedDate not supplied

Fluid balance charts: do they measure up?

Many current nursing activities are performed without regular reviews of their usefulness. The recording of fluid gains and losses on a fluid balance chart is one such activity. This article explores the practice of fluid monitoring on the wards of a university teaching hospital.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

Influence of volume replacement with colloids versus crystalloids in neonates on venoarterial extracorporeal membrane oxygenation on fluid retention, fluid balance, and ECMO runtime.

In this retrospective study, we compared the effects of colloid versus crystalloid fluid replacement on the clinical signs of capillary leakage syndrome in 30 neonates with pulmonary hypertension due to meconium aspiration syndrome on venoarterial membrane oxygenation (VA-ECMO). Before 2000, 15 neonates received volume replacement with a pasteurized plasma protein solution (3.8% albumin); after 2000, 15 neonates received normal saline. Patient characteristics and pre-ECMO values did not differ between the two groups. Total fluid balance was also equal. Diuretic use was significantly higher in the colloid group (p < 0.001). The chest wall soft-tissue index was significantly higher in the crystalloid group (p < 0.005), as were the ventilator settings at the end of the ECMO runtime (p < 0.05). Serum colloid osmotic pressure, albumin, urea nitrogen, and creatinine were significantly higher in the colloid group (p < 0.0001, < 0.0001, < 0.001, and < 0.05, respectively). Duration of VA-ECMO, of artificial ventilation after ECMO treatment, and the mortality rate did not differ between the two groups. We conclude that volume replacement with crystalloids in neonates on VA-ECMO aggravated the edema in a preexisting situation of capillary leakage syndrome, whereas volume replacement with colloids could impair the kidney function.

Capillary Leak Syndrome↗
PubMed1989

Effects of an aorticopulmonary shunt on lung fluid balance in the young lamb.

We studied the effects of increased pulmonary blood flow on lung fluid balance in seven chronically instrumented lambs (18 +/- 1 d) with surgically created aorticopulmonary shunts. We measured mean pulmonary arterial and left atrial pressure (LAP), pulmonary blood flow, lung lymph flow, and lymph (CL) and plasma (CP) protein concentration with the shunt closed and opened. With the shunt partially open, a 35% increase in pulmonary blood flow resulted in an increase in pulmonary arterial pressure (15.5 +/- 1 to 19.5 +/- 1 torr) and LAP (2.0 +/- 0.5 to 3.5 +/- 0.5 torr). Lung lymph flow nearly doubled (1.53 +/- 0.28 to 2.83 +/- 0.52 mL/h) whereas the CL decreased (4.1 +/- 0.1 to 3.4 +/- 0.1 g/dL) resulting in a decrease in the CL/CP ratio (0.67 +/- 0.01 to 0.58 +/- 0.01). With the shunt fully open, pulmonary blood flow increased 65% over baseline, pulmonary arterial pressure increased from 16.5 +/- 2.0 to 26.5 +/- 5 torr, and LAP increased from 1.5 +/- 0.5 to 6.5 +/- 2.0 torr. Lung lymph flow increased (1.1 +/- 0.2 to 3.1 +/- 0.2 mL/h) whereas CL (4.1 +/- 0.1 to 3.1 +/- 0.3 g/dL) and CL/CP (0.66 +/- 0.02 to 0.51 +/- 0.05) decreased. All changes were statistically significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1954

The chloride-water balance sheet; an aid in the management of difficult fluid balance problems.

In cases in which there is massive loss of fluids or electrolytes or prolonged decreased urinary output, an absolutely accurate knowledge of all water and chloride intake and output by all routes is necessary to avert large and often fatal errors in water and electrolyte therapy based on estimates made from nurses' notes alone. By use of the Scribner water-chloride balance sheet method of recording data, it is possible to determine with the necessary accuracy how much fluid and what kind of electrolytes to administer to achieve and maintain balance. The method is simple and can be put into effect in any hospital with the cooperation of an educated nursing and laboratory staff.

Acid-Base Imbalance↗
PubMed2006

How perioperative fluid balance influences postoperative outcomes.

Fasting, anaesthesia and surgery affect the body's physiological capacity not only to control its external fluid and electrolyte balance but also the internal balance between the various body fluid compartments. Conversely, abnormalities of fluid and electrolyte balance may adversely affect organ function and surgical outcome. Perioperative fluid therapy has a direct bearing on outcome, and prescriptions should be tailored to the needs of the patient. The goal of fluid therapy in the elective setting is to maintain the effective circulatory volume while avoiding interstitial fluid overload whenever possible. Weight gain in elective surgical patients should be minimized in an attempt to achieve a 'zero fluid balance status'. On the other hand, these patients should arrive in the anaesthetic room in a state of normal fluid and electrolyte balance so as to avoid the need to resuscitate fluid-depleted patients in the anaesthetic room or after the induction of anaesthesia. Optimal fluid delivery should be part of an overall care package that involves minimization of the period of preoperative fasting, preoperative carbohydrate loading, thoracic epidural analgesia, avoidance of nasogastric tubes, early mobilization, and early return to oral feeding, as exemplified by the enhanced recovery after surgery programme.

Fluid Therapy↗
PubMed1990

Measurement of dynamic lung fluid balance in the mechanically ventilated dog. Theory and results.

An expression (LN) is presented for the net fluid leakage from the intravascular to the extravascular space in the lung. It is based on a new dog model and is the sum of rate of change in extravascular lung water content (EVLW), thoracic lymph flow, and pleural fluid formation. The rate of change of EVLW (delta EVLW) in ml/kg/h was calculated from repeated measurements of EVLW with a double-indicator dilution technique (dye/cold) and corrected according to the relation between EVLW measured by this technique and gravimetry. LN was studied in lung-healthy mechanically ventilated dogs during a prolonged period of mechanical ventilation with and without the application of a positive end-expiratory pressure of 10 cmH2O (1.0 kPa). During mechanical ventilation, LN was found to be 0.3 ml/kg/h in the basal condition, increasing to 0.5 ml/kg/h (P less than 0.01) after a mean period of 7 h. After the application of a positive end-expiratory pressure (PEEP) of 10 cmH2O (1 kPa) for 0.5-2 h, LN was found to increase significantly, from a mean of 0.3 ml/kg/h to 0.9 ml/kg/h (P less than 0.01). We conclude that LN is a useful quantitative expression in experimental studies on lung fluid balance.

Animals↗
PubMed1983

Effects of hypoproteinemia and increased vascular pressure on lung fluid balance in sheep.

We compared the effects of a sustained decrease in plasma oncotic pressure on lung fluid balance with those of an increase in vascular pressure in six unanesthetized sheep. Initial plasma protein concentration of 58.0 +/- 2.2 (SE) mg/ml was quickly reduced to 34.0 +/- 1.4 mg/ml via plasmapheresis and held at this value for 24 h. Red cells were returned with lactated Ringer solution infused at a rate adjusted to maintain central venous pressure; cardiac output and pulmonary vascular pressures also remained at base line. Steady-state lymph flows increased from a base-line value of 8.8 +/- 3.2 to 20.1 +/- 5.6 ml/h, while the lymph-to-plasma protein concentration ratio ( [L/P] ) decreased from 0.65 +/- 0.03 to 0.44 +/- 0.04. Decreased lymph protein resulted in reestablishment of base-line plasma-to-lymph oncotic gradient. The increased lymph flow was not the result of increased filtration forces, since all vascular pressures and the oncotic gradient were unchanged; nor was it due entirely to increased surface area since [L/P] was decreased. The decrease in plasma oncotic pressure, delta pi P, was twice as effective at increasing lymph flow (1.66 ml X h-1 X mmHg-1, delta pi P) as an equivalent increase in microvascular pressure, delta PC, at normal plasma protein concentration (0.82 ml X h-1 X mmHg-1, delta PC). Elevation of microvascular pressure during hypoproteinemia had a greater effect on lymph flow (1.44 ml X h-1 X mmHg-1, delta PC) than at normal plasma protein concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Antepartum to postpartum changes in transcapillary fluid balance.

During the puerperium significant changes occur in the body volume homeostasis. In the present study the transcapillary fluid balance was examined antepartum in nine healthy women. The interstitial colloid osmotic pressure was measured by the 'wick' method, and interstitial hydrostatic pressure by the 'wick-in-needle' method in subcutaneous tissue on the thorax and at the ankle. From antepartum (gestational week 37-40) to postpartum (5th day), the following changes were observed: A significant increase in the colloid osmotic pressure both in plasma (mean 1.8 mmHg, P = 0.027) and in the interstitial fluid at the ankle (mean 2.9 mmHg, P = 0.008). Neither colloid osmotic pressure gradient (plasma-interstitium), interstitial hydrostatic pressure, nor haemoglobin and haematocrit changed. The observed rise in the interstitial colloid osmotic pressure must be caused by mobilization of fluid from the interstitium, probably due to a reduced capillary hydrostatic pressure. The increase in plasma colloid osmotic pressure is most likely caused by an increased albumin synthesis and/or transport of interstitial proteins back to the vascular compartment.

Adult↗
PubMed1992

Neuroendocrine, fluid balance, and thirst responses to alcohol in alcoholics.

This study simultaneously evaluated multiple circulating neurohormones, osmolality, thirst, and fluid balance in eight actively drinking, alcoholic males and seven controls before and 12 hr after an ethanol challenge. Basal levels of serum osmolality and thirst were significantly higher in alcoholics compared with controls, yet actively drinking alcoholics at the start of the study had normal vasopressin (AVP) levels, plasma angiotensin II (Ang II), plasma renin activity, plasma aldosterone (Aldo), and plasma catecholamines. In response to ethanol, serum osmolalities rose significantly higher while plasma AVP levels became significantly suppressed in alcoholics. After the ethanol stimulus, plasma Ang II levels of alcoholics were significantly higher than those of controls at 11 AM (12.15 +/- 4.49 vs. 1.83 +/- 0.6 pg/ml, p less than 0.02) and 12 noon (14.93 +/- 6.81 vs. 1.37 +/- 0.17 pg/ml, p less than 0.04). Neither plasma renin activity nor Aldo changed in accordance with the elevated plasma Ang II in alcoholics. Diuresis in the alcoholics, assessed by the sum of urine output following the challenge dose, was significantly less than that of controls. Thirst scores and fluid intakes after the ethanol challenge did not differ between alcoholics and controls. The lack of an Ang II-mediated increase in plasma Aldo or thirst response suggests that ethanol may have a specific blunting effect on Ang II receptors. This study demonstrates that ethanol can be used as a provocative test in chronic alcoholics to uncover aberrant hormonal responses for two systems, namely, Ang II and AVP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

The effects of a liquid ethanol diet on nutritional status and fluid balance in the rat.

The liquid ethanol diet is a widely used method of ethanol administration. The purpose of this study was to evaluate fluid balance using a multitude of physiological parameters (electrolytes, osmolality, total serum proteins, fluid intake/output and body weight), during and after the introduction of liquid ethanol diet. Animals were randomized into four different dietary protocols (two control and two ethanol groups) and were placed in metabolic cages for 16 days. Serum electrolytes, as well as the above parameters, were measured before, during and 1 week after the introduction of 9% (v/v) ethanol-containing diet (Lieber-DeCarli: LD). After the first night on 9% (v/v) ethanol LD, animals had significantly decreased diet consumption, urine output and body weight. However, a major finding of this study was that, during the habituation phase, the electrolyte values remained within the normal range for rats and, in particular, serum sodium was not altered at any time point measured in this study. Based upon the findings from this study, it is recommended that body weight be carefully monitored as a measure of the animal's equilibration and physiological adaptation during the initiation of a liquid ethanol diet, since neither the serum sodium nor calculated osmolality values were changed. Our results also highlight the need to offer water to animals during the habituation phase of ethanol consumption. This is because ethanol rats that were offered water ad libitum lost less weight than groups that did not receive water ad libitum, despite consuming the same amount of LD diet.

Analysis of Variance↗
PubMed1991

Effects of 1.5% glycine solution with and without 1% ethanol on the fluid balance in elderly men.

Ten male patients scheduled for transurethral prostatic resection (aged 57-79) were given irrigating fluid by intravenous infusion at 50 ml.min-1 over 20 min. Each patient was subjected to two infusions: 1.5% glycine in water on one occasion, and the same solution but with 1% ethanol added on the other. Urine and blood samples were collected at regular intervals for up to 2 h after infusion, and the changes in the distribution of water and electrolytes between fluid compartments were calculated. Transient prickling skin sensations were frequently reported effects of the infusions. Two patients experienced visual disturbances. There were no changes in the blood ammonia and plasma vasopressin levels. During the infusions, the estimated blood volume and the total plasma sodium and potassium content increased. The solutions produced osmotic diuresis with increased urinary excretion of water and electrolytes. After ending the fluid administration, blood volume was rapidly restored. Over the following 120 min the irrigant water was redistributed intracellularly or removed by urinary excretion. The addition of ethanol did not alter the overall effects of glycine solution on the fluid balance.

Absorption↗
PubMed1976

[The significance of the veins for transcapillary fluid balance].

Various results from experimental as well as from theoretical studies challenge the classical concept of the Starling hypothesis of fluid balance between blood and tissue. Although most of these considerations are based on work with animal preparations, the following points appear to be applicable to human physiology: 1. The values of pressure as measured directly in venules, prohibit reabsorption of fluid from the interstitium. In addition, due to the increased permeability of the venular vessel wall to macromolecules, filtration of plasma proteins takes place at the venular end of the capillaries. 2. The overall permeability of the vessel walls to the proteins, is up to 20 times smaller than was previously assumed. Therefore, the total amount of filtered fluid is reduced to the volume range of the lymphatic transport. 3. The total amount of filtered proteins is brought back to the blood circulation via the lymphatic system. Thus, there is unidirectional slow movement of macromolecules with free fluid from the capillaries across the interstitial space toward the terminal lymphatics. However, exchange of small molecular substances such as water, gases, minerals and sugar by diffusion, is practically unlimited by the blood-tissue barrier. 4. As a practical example, the pressure values in the superficial veins of the human leg clearly exceed the limits for reabsorption of fluid from the tissue. The absence of edema in the normal human legs remains unexplained, if the lymphatic transport is not taken into account as an essential part of the system. Thus, the dynamic equilibrium of the fluid exchange is disturbed, either by increased transcapillary filtration (e. g. increase in venous pressure or microvascular permeability), by impaired lymphatic capacity or by a combination of these two factors.

Capillaries↗