Summary
Blood volume and extracellular fluid volume were measured in eight patients with51Cr and35S respectively before and after general surgical operations.
After operation red cell volume was decreased 3.4% and plasma volume was decreased 15.9%. The interstitial fluid was increased 22.8% and extracellular fluid was increased 15.5%. The expansion of extracellular fluid was due to massive fluid infusion during the operation and the early postoperative period.
After correction for the amount of fluid given and the urine excreted there was no significant change in extracellular fluid volume compared with the preoperative value.
The different results of other investigators are considered to be due to methodological problems.
It is concluded that there is no need for massive therapy with crystalloid solutions following extensive general surgery in view of the absence of a real deficit in the extracellular fluid space.
Zusammenfassung
Bei acht Patienten wurden Blutvolumen und extracelluläre Flüssigkeit mit51Cr und35S vor und nach allgemeinchirurgischen Eingriffen gemessen. Nach den Operationen war das Erythrocytenvolumen um durchschmittlich 3,4% und das Plasmavolumen um 15,9% vermindert. Die interstitielle Flüssigkeit war um 22,8% und die extracelluläre Flüssigkeit um 15,5% vermehrt. Die Zunahme der extracellulären Flüssigkeit war bedingt durch massive Flüssigkeitsinfusionen während der Operation und in der frühen postoperativen Phase.
Bei Berücksichtigung von Infusionsmenge und Urinausscheidung ergab sich keine signifikante Veränderung der extracellulären Flüssigkeit gegenüber den präoperativen Kontrollwerten. Die unterschiedlichen Ergebnisse anderer Untersucher werden methodisch erklärt.
Es wird gefolgert, daß vonseiten der extracellulären Flüssigkeit keine Notwendigkeit für eine massive Therapie mit Elektrolytlösungen während operativer Eingriffe besteht.
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Die Untersuchungen wurden durchgeführt in der Division of Thoracic Surgery des Department of Surgery der University of California, Los Angeles, und unterstützt durch United States Public Health undFrank Clark, Jr., Charities, Inc.
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Roth, E., Lax, L.C. & Maloney, J.V. Operationstrauma und extracelluläre Flüssigkeit. Arch. f. klin. Chir 323, 154–161 (1968). https://doi.org/10.1007/BF01441332
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DOI: https://doi.org/10.1007/BF01441332