Skip to main content
SpringerLink
Log in
Book cover

Body Fluid Management pp 255–274Cite as

Fluid Management: Questions and Answers

  • Chapter

  • 3455 Accesses

Abstract

Body water accounts for approximately 60% of body weight; it is mainly distributed in the extracellular and intracellular spaces (ECS and ICS, respectively). The ICS contains nearly 55% of the water, and the ECS 45% (about 15 L in a normal adult). The ECS is further divided into the intravascular space (IVS), the interstitial space (ISS), and the transcellular space (TCS), containing about 15%, 45%, and 40% of ECS water, respectively. The TCS is a functional compartment represented by the amount of fluid and electrolytes continually exchanged (in and out) by cells with the ISS and by the IVS with the ISS.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Voet D, Voet JG, Pratt CW (2001) Fundamentals of Biochemistry (Rev. ed.). New York, Wiley

    Google Scholar 

  2. Amiji MM, Sandmann BJ (2002) Applied Physical Pharmacy. McGraw-Hill Professional

    Google Scholar 

  3. Williams EL, Hildebrand KL, McCormick SA et al (1999) The effect of intravenous lactated Ringer’s solution versus 0.9 % sodium chloride solution on serum osmolality in human volunteers. Anesth Analg 88:999–1003

    PubMed  CAS  Google Scholar 

  4. Tommasino C, Moore S, Todd MM (1988) Cerebral effects of isovolemic hemodilution with crystalloid or colloid solutions. Crit Care Med 16:862–868

    Article  PubMed  CAS  Google Scholar 

  5. Schell RM, Applegate RL, Cole DJ (1996) Salt, starch, and water on the brain. J Neurosurg Anesth 8:179–182

    Article  Google Scholar 

  6. Arieff AI, Llach F, Massry SG (1976) Neurological manifestations and morbidity of hyponatremia: Correlation with brain water and electrolytes. Medicine 55:121–129

    Article  PubMed  CAS  Google Scholar 

  7. Jayashree M, Singhi S (2004) Diabetic ketoacidosis: Predictors of outcome in a pediatric intensive care unit of a developing country. Pediatr Crit Care Med 5:427–433

    Article  PubMed  CAS  Google Scholar 

  8. Boyd DR, Mansberger AR Jr (1968) Serum water and osmolal changes in hemorrhagic shock: An experimental and clinical study. Amer Surg 34:744–749

    CAS  Google Scholar 

  9. Järhult J (1973) Osmotic fluid transfer from tissue to blood during hemorrhagic hypotension. Acta Physiol Scand 89:213–226

    Article  PubMed  Google Scholar 

  10. Kenney PR, Allen-Rowlands CF, Gann DS (1983) Glucose and osmolality as predictors of injury severity. J Trauma 23:712–71

    Article  PubMed  CAS  Google Scholar 

  11. Sukanya Mitra and Purva Khandelwal (2009) Are All Colloids Same? How to Select the Right Colloid? Indian Journal of Anaesthesia 53:592

    Google Scholar 

  12. Dubois MJ, Vincent JL (2007) Colloid Fluids. In: Hahn RG, Prough DS, Svensen CH (eds.) Perioperative Fluid Therapy, 1 edn. New York, Wiley, pp 153–611

    Google Scholar 

  13. Kaminski MV, Williams SD (1990) Review of the rapid normalization of serum albumin with modified total parenteral nutrition solutions. Crit Care Med 18:327–35

    Article  PubMed  Google Scholar 

  14. Rajnish KJ et al (2004) Albumin: an overview of its place in current clinical practice. J Indian An

    Google Scholar 

  15. Schnitzer JE, Carley WW, Palade GE (1988) Specific albumin binding to microvascular endothelium in culture. Am J Physiol 254:H425–27

    PubMed  CAS  Google Scholar 

  16. Moran M, Kapsner C (1987) Acute renal failure associated with elevated plasma oncotic pressure. N Engl J Med 317:150–3

    Article  PubMed  CAS  Google Scholar 

  17. Levi M, Jonge E (2007) Clinical relevance of the effects of plasma expanders on coagulation. Semin Thromb Haemost 33:810–815

    Article  CAS  Google Scholar 

  18. Solanke TF, Khwaja MS, Kadomemu EL (1971) Plasma volume studies with four different plasma volume expanders. J Surg Res 11:140–43

    Article  PubMed  CAS  Google Scholar 

  19. Mitral S, Khandelwal P (2009) Are All Colloids Same? How to Select the Right Colloid? Indian J Anaesth 53:592–607

    Google Scholar 

  20. Ramani Moonesinghe S, Mythen MG, Grocott MPW (2011) High risk surgery: epidemiology and Outcomes. Anesth Analg 112:891–901

    Article  PubMed  Google Scholar 

  21. Soni N (2009) British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients (GIFTASUP): Cassandra’s view. Anaesthesia 64:235–8

    Article  PubMed  CAS  Google Scholar 

  22. Brandstrup B, Tonnesen H, Beier-Holgersen R et al (2003) Effects of intravenous fluid restriction on postoperative complications: Comparison of two perioperative fluid regimens — a randomized assessor-blinded multicenter trial. Ann Surg 238:641–8

    Article  PubMed  Google Scholar 

  23. Lobo DN, Bostock KA, Neal KR et al (2002) Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: A randomised controlled trial. Lancet 359:1812–8

    Article  PubMed  Google Scholar 

  24. Della Rocca G, Costa MG (2005) Volumetric monitoring: principles of application. Minerva Anestesiol 71:303–306

    PubMed  Google Scholar 

  25. McIlroy DR, Kharasch ED (2003) Acute intravascular volume expansion with rapidly administered crystalloid or colloid in the setting of moderate hypovolemia. Anesth Analg 96:1572–7

    Article  PubMed  Google Scholar 

  26. Matharu NM, Butler LM, Rainger GE et al (2008) Mechanisms of the anti-inflammatory effects of hydroxyethyl starch demonstrated in a flow-based model of neutrophil recruitment by endothelial cells. Crit Care Med. May 36:1536–42

    Article  CAS  Google Scholar 

  27. Jacob M, Bruegger D, Rehm M et al (2006) Contrasting effects of colloid and crystalloid resuscitation fluids on cardiac vascular permeability. Anesthesiology 104:1223–31

    Article  PubMed  CAS  Google Scholar 

  28. Vercauteren HP, Hoffman V, Coppejans HC (1996) Hydroxyethyl starch compared with modified gelatin as volume preload before spinal anaesthesia for caesarean section. Br J Anaesth 76:731–3

    Article  PubMed  CAS  Google Scholar 

  29. Riley ET, Cohen SE, Rubenstein AJ, Flanagan B (1995) Prevention of hypotension after spinal anesthesia for cesarean section: Six percent hetastarch versus lactated Ringer’s solution. Anesth Analg 81:838–42

    PubMed  CAS  Google Scholar 

  30. Laxenaire M, Charpentier C, Feldman L (1994) Réactions anaphylactoïdes aux substituts colloïdaux du plasma: incidence, facteurs de risque, mécanismes. Enquête prospective, multi-centrique française. Annales Françaises d’Anesthésie et Reanimation 13:301–310

    Article  CAS  Google Scholar 

  31. Svensen C, Hahn RG (1997) Volume kinetics of Ringer solution, dextran 70, and hypertonic saline in male volunteers. Anesthesiology 87:204–12

    Article  PubMed  CAS  Google Scholar 

  32. Connolly CM, Kramer GC, Hahn RG et al (2003) Isoflurane but not mechanical ventilation-promotes extravascular fluid accumulation during crystalloid volume loading. Anesthesiology 98:670–81

    Article  PubMed  Google Scholar 

  33. Holte K, Kehlet H (2002) Compensatory fluid administration for preoperative dehydration — does it improve outcome? Acta Anaesthesiol Scand 46:1089–93

    Article  PubMed  CAS  Google Scholar 

  34. Maharaj CH, Kallam SR, Malik A et al (2005) Preoperative intravenous fluid therapy decreases postoperative nausea and pain in high risk patients. Anesth Analg 100:675–8

    Article  PubMed  CAS  Google Scholar 

  35. Ali SZ, Taguchi A, Holtmann B, Kurz A (2003) Effect of supplemental pre-operative fluid on postoperative nausea and vomiting. Anaesthesia 58:780–4

    Article  PubMed  CAS  Google Scholar 

  36. Gan TJ, Soppitt A, Maroof M et al (2002) Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 97:820–6

    Article  PubMed  Google Scholar 

  37. Wakeling HG, McFall MR, Jenkins CS et al (2005) Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth 95:634–42

    Article  PubMed  CAS  Google Scholar 

  38. Fries D, Innerhofer P, Klingler A et al (2002) The effect of the combined administration of colloids and lactated Ringer’s solution on the coagulation system: an in vitro study using thrombelastograph coagulation analysis (ROTEG. Anesth Analg 94:1280–7

    Article  PubMed  CAS  Google Scholar 

  39. VG (2005) Colloids decrease clot propagation and strength: role of factor XIII-fibrin polymer and thrombin-fibrinogen interactions. Acta Anaesthesiol Scand 49:1163–71

    Article  Google Scholar 

  40. Langeron O, Doelberg M, Ang ET et al (2001) Voluven®, a lower substituted novel hydroxyethyl starch (HES 130/0.4) causes fewer effects on coagulation in major orthopedic surgery than HES 200/0.5 Anesth Analg 92:855–62

    Article  PubMed  CAS  Google Scholar 

  41. Oeveren W, Hagenaars A, Tigchelaar I et al (1998) Increased von Willebrand factor after low molecular weight hydroxyethyl starch priming solution in cardiopulmonary bypass. Br J Anaesth 80(Suppl 1):A267

    Google Scholar 

  42. Huet R, Siemons W, Hagenaars A, van Oeveren W (1998) Is hydroxyethyl starch 130/0.4 the optimal starch plasma substitute in adult cardiac surgery? Anesth Analg 86(Suppl 4):SCA80

    Google Scholar 

  43. Konrad CJ, Markl TJ, Schuepfer GK et al (2000) In vitro effects of different medium molecular hydroxyethyl starch solutions and lactated ringer’s solution on coagulation using sonoclot for analysis. Anesth Analg 90:274–9

    PubMed  CAS  Google Scholar 

  44. Papakitsos G, Papakitsou T, Kapsali A (2010) A total balanced volume replacement strategy using a new balanced 6% hydroxyethyl starch preparation Tetraspan (HES 130/0.42) in patients undergoing major orthopaedic surgery: 6AP3-1. European Journal of Anaesthesiology 27:106

    Article  Google Scholar 

  45. Rackow EC, Falk JL, Fein IA et al (1983) Fluid resuscitation in circulatory shock: a comparison of the cardio-respiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med 11:839–850

    Article  PubMed  CAS  Google Scholar 

  46. Foglia RP, Lazar HL, Steed DL et al (1978) Iatrogenic myocardial edema with crystalloid primes: effects on left ventricular compliance, performance and perfusion. Surg Forum 29:312–315

    PubMed  CAS  Google Scholar 

  47. Hoeft A et al (1991) Priming of cardiopulmonary bypass with human albumin or Ringer’s Lactate: effect on colloiosmotic pressure and extravascular lung water. Br J Anesth 66:73–80

    Article  CAS  Google Scholar 

  48. Sade RM, Stroud MR, Crawford FA Jr et al (1985) A prospective randomized study of hydroxyethyl starch, albumin, and lactated Ringer’s solution as priming fluid for cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 89:713–722

    PubMed  CAS  Google Scholar 

  49. Gallandat Huet RC, Siemons AW, Baus D et al (2000) A novel hydroxyethyl starch (Voluven) for effective perioperative plasma volume substitution in cardiac surgery. Can J Anaesth 47:1207–1215

    Article  PubMed  CAS  Google Scholar 

  50. Haisch G, Boldt J, Krebs C et al (2001) Influence of a new hydroxyethylstarch preparation (HES 130/0.4) on coagulation in cardiac surgical patients. J Cardiothorac Vasc Anesth 15:316–321

    Article  PubMed  CAS  Google Scholar 

  51. American Thoracic Society Consensus Statement (2004) Evidence-based colloid use in the critically ill. Am J Respir Crit Care Med 1247–1259

    Google Scholar 

  52. Groeneveld ABJ, Navickis RJ, Wilkes MM (2011) Update on the comparative safety of colloids: a systematic review of clinical studies. Ann Surg 253:470–483

    Article  PubMed  Google Scholar 

  53. Hartog CS, Bauer M, Reinhart K (2011) The efficacy and safety of colloid resuscitation in the critically Ill. Anesth Analg 112:156–64

    Article  PubMed  CAS  Google Scholar 

  54. Dellinger RP et al (2008) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36:296–327

    Article  PubMed  Google Scholar 

  55. Bratton SL et al (2007) Guidelines for the management of severe traumatic brain injury. II. Hyperosmolar therapy. J Neurotrauma 24(suppl 1):S14–20

    PubMed  Google Scholar 

  56. Patanwala AE et al (2010) Use of hypertonic saline injection in trauma. Am J Health Syst Pharm 67:1920–8

    Article  PubMed  Google Scholar 

  57. Cotton BA et al (2009) Guidelines for prehospital fluid resuscitation in the injured patient. J Trauma 67:389–402

    Article  PubMed  Google Scholar 

  58. Tam N et al. American Burn Association (2008) American Burn Association practice guidelines burn shock resuscitation. J Burn Care Res 29:257–66

    Google Scholar 

  59. Vlachou E et al (2010 Nov) Hydroxyethylstarch supplementation in burn resuscitation—a prospective randomised controlled trial. Burns 36:984–91

    Article  PubMed  CAS  Google Scholar 

  60. Sümpelmann R, Becke K, Crean P et al (2011) European consensus statement for intraoperative fluid therapy in children. Eur J Anaesthesiol 28:637–639

    Article  PubMed  Google Scholar 

  61. Haas T, Preinreich A, Oswald E et al (2007) Innerhofer Effects of albumin 5% and artificial colloids on clot formation in small infants) Anaesthesia 62:1000–7

    Article  PubMed  CAS  Google Scholar 

  62. Suempelmann R, Witt L, Brütt M et al (2010) Changes in acid-base, electrolyte and hemoglobin concentrations during infusion of hydroxyethyl starch 130/0.42/6:1 in normal saline or in balanced electrolyte solution in children. Paediatr Anaesth 20:100–4. Epub

    Article  Google Scholar 

  63. Bailey AG, McNaull PP, Jooste E, Tuchman JB (2010) Perioperative crystalloid and colloid fluid management in children: where are we and how did we gethere? Anesth Analg 110:375–390

    Article  PubMed  Google Scholar 

  64. Moritz M, Ayus JC (2010) Water water everywhere: standardizing postoperative fluid therapy with 0.9% normal saline. Anesth Analg 110:293–5

    Article  PubMed  Google Scholar 

  65. Montañana PA, Modesto i Alapont V, Ocón AP et al (2008) The use of isotonic fluid as maintenance therapy prevents iatrogenic hyponatremia in pediatrics: a randomized, controlled open study. Pediatr Crit Care Med 9:589–97

    Article  PubMed  Google Scholar 

  66. Neville KA, Sandeman DJ, Rubinstein A et al (2010) Prevention of hyponatremia during maintenance intravenous fluid administration: a prospective randomized study of fluid type versus fluid rate. J Pediatr 156:313–9

    Article  PubMed  CAS  Google Scholar 

  67. Waters J, Gottlieb A, Schoenwald P (2001) Normal saline versus lactated Ringer’s solution for intra-operative fluid management in patients undergoing abdominal aortic aneurysm repair: an outcome study. Anesth Analg 93:817–22

    Article  PubMed  CAS  Google Scholar 

  68. Houghton J, Wilton N (2011) Choice of isotonic perioperative fluid in children. Anesth Analg 112:246–7; Roth JV. Pediatric postoperative fluid therapy: avoiding hyponatremia

    Article  PubMed  Google Scholar 

  69. Harrison MJG (1989) Influence of haematocrit in the cerebral circulation. Cerebrovasc Brain Metabol Rev 1:55–67

    CAS  Google Scholar 

  70. Hudak ML, Koehler RC, Rosenberg AA et al (1986) Effect of hematocrit on cerebral blood flow. Am J Physiol 251:H63–70

    PubMed  CAS  Google Scholar 

  71. Todd MM, Wu B, Warner DS (1994) The hemispheric cerebrovascular response to hemodilution is attenuated by a focal cryogenic brain injury. JNeurotrauma 11:149–60

    Article  CAS  Google Scholar 

  72. Tommasino C, Ravussin P (1994) Oncotic pressure and hemodilution. Ann Fran Anesth Reanim 13:62–7

    Article  CAS  Google Scholar 

  73. DK, Ryu KH, Hindman BJ et al (1996) Marked hemodilution increases neurologic injury after focal cerebral ischemia in rabbits. Anesth Analg 82:61–7

    Google Scholar 

  74. Tommasino C (2002) Fluids and the neurosurgical patient. Anesthesiology Clin N Am 20:329–346

    Article  Google Scholar 

  75. Shenkin HA, Benzier HO, Bouzarth W (1976) Restricted fluid intake: rational management of the neurosurgical patient. J Neurosurg 45:432-6

    Article  PubMed  CAS  Google Scholar 

  76. Atrash HK, Koonin LM, Lawson HW et al (1990) Maternal mortality in the United States, 1979–1986. Obstet Gynecol 76:1055

    PubMed  CAS  Google Scholar 

  77. Kamani AA, McMorland GH, Wadsworth LD (1988) Utilization of red blood cell transfusion in an obstetric setting. Am J Obstet Gynecol 159:1177

    PubMed  CAS  Google Scholar 

  78. Kapholz H (1990) Blood transfusion in contemporary obstetric practice. Obstet Gynecol 75:940

    Google Scholar 

  79. Van der Linden P, Ickx BE (2006) The effects of colloid solutions on hemostasis. Can J Anaesth 53(6 Suppl):S30–S39

    PubMed  Google Scholar 

  80. Finfer S, Bellomo R, Boyce N et al (2004) A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 350:2247–2256

    Article  PubMed  CAS  Google Scholar 

  81. Boldt J (2007) The balanced concept of fluid resuscitation. Br J Anaesth 99:312–315

    Article  PubMed  CAS  Google Scholar 

  82. Mion G, Rüttimann M (1997) Loading with hypertonic saline solution during pregnancy toxemia. Ann Fr Anesth Reanim 16:1046–1047

    Article  PubMed  CAS  Google Scholar 

  83. Clark SL, Greenspoon JS, Aldahl D et al (1986) Severe preeclampsia with persistent oliguria: Management of hemodynamic subsets. Am J Obstet Gynecol 154:490

    PubMed  CAS  Google Scholar 

  84. Kapholz H (1990) Blood transfusion in contemporary obstetric practice. Obstet Gynecol 75:940

    Google Scholar 

  85. Seymour DG, Henschke PJ, Cape RD, Campbell AJ (1980) Acute confusional states and dementia in the elderly: the roles of dehydration/volume depletion, physical illness and age. Age Ageing 9:137–146

    Article  PubMed  CAS  Google Scholar 

  86. Bruera E, Franco JJ, Maltoni M, Watanabe S, Suarez-Almazor M (1995) Changing patterns of agitated impaired mental status in patients with advanced cancer: association with cognitive monitoring, hydration, and opioid rotation. J Pain Symptom Manage 10:287–291

    Article  PubMed  CAS  Google Scholar 

  87. Inouye SK, Bogardus ST Jr, Charpentier PA et al (1999) A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 340:669–676

    Article  PubMed  CAS  Google Scholar 

  88. Wildiers H, Menten J (2002) Death rattle: prevalence, prevention and treatment. J Pain Symptom Manage 23:310–7

    Article  PubMed  Google Scholar 

  89. Dalal S, Bruera E (2004) Dehydration in cancer patients: to treat or not to treat. J Support Oncol 2:467–487

    PubMed  Google Scholar 

  90. Ellershaw JE, Sutcliffe JM, Saunders CM (1995) Dehydration and the dying patient. Journal of pain and symptom management 10:192–197

    Article  PubMed  CAS  Google Scholar 

  91. Dunlop RJ, Ellershaw JE, Baines MJ, Sykes N, Saunders CM (1995) On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far? A reply Journal of medical ethics 21:141–143

    Article  CAS  Google Scholar 

  92. Van Hulst RA, Klein J, Lachmann B (2003) Gas embolism: pathophysiology and treatment. Clin Physiol Funct Imaging 23:237–46

    Article  PubMed  Google Scholar 

  93. Guidet B (2010) A balanced view of balanced solutions. Crit Care 14:325

    Article  PubMed  Google Scholar 

  94. Grocott MPW (2005) Perioperative fluid management and clinical outcomes in adults. Anesth Analg 100:1093–106

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Postgraduate School of Anesthesia and Intensive Care, Anesthesia, Intensive Care and Pain Management Department, University School of Medicine Campus Bio-Medico of Rome, Rome, Italy

    Chiara Candela

Authors
  1. Maria Benedetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chiara Candela
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Felice Eugenio Agrò
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chiara Candela .

Editor information

Editors and Affiliations

  1. Intensive Care and Pain Management Department, University School of Medicine Campus Bio-Medico of Rome, Rome, Italy

    Felice Eugenio Agrò MD (Commander to the Order of Merit of the Italian Republic, Full Professor of Anesthesia and Intensive Care, Chairman of Postgraduate School of Anesthesia and Intensive Care, Director of Anesthesia) (Commander to the Order of Merit of the Italian Republic, Full Professor of Anesthesia and Intensive Care, Chairman of Postgraduate School of Anesthesia and Intensive Care, Director of Anesthesia)

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Italia

About this chapter

Cite this chapter

Benedetto, M., Candela, C., Agrò, F.E. (2013). Fluid Management: Questions and Answers. In: Agrò, F.E. (eds) Body Fluid Management. Springer, Milano. https://doi.org/10.1007/978-88-470-2661-2_20

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2661-2_20

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2660-5

  • Online ISBN: 978-88-470-2661-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation