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Perioperative fluid management: comparison of high, medium and low fluid volume on tissue oxygen pressure in the small bowel and colon

Published online by Cambridge University Press:  01 November 2007

L. B. Hiltebrand ,
G. Pestel ,
H. Hager ,
J. Ratnaraj ,
G. H. Sigurdsson  and
A. Kurz
L. B. Hiltebrand*
Affiliation:
Washington University, Department of Anesthesiology, St. Louis, MO, USA
G. Pestel
Affiliation:
University of Bern, Department of Anesthesiology, Inselspital, Bern, Switzerland
H. Hager
Affiliation:
Washington University, Department of Anesthesiology, St. Louis, MO, USA
J. Ratnaraj
Affiliation:
Washington University, Department of Anesthesiology, St. Louis, MO, USA
G. H. Sigurdsson
Affiliation:
Landspitali University Hospital and University of Iceland, Department of Anesthesia and Intensive care medicine, Reykjavik, Iceland
A. Kurz
Affiliation:
University of Louisville, Outcomes Research Institute, Louisville, KY, USA
*
Correspondence to. Luzius Hiltebrand, Department of Anaesthesiology, Inselspital, University of Bern, 3010 Bern, Switzerland. E-mail: luzius.hiltebrand@insel.ch; Tel: +41 31 362 24 83; Fax: +41 31 632 05 54
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Summary

Background and objective

Insufficient blood flow and oxygenation in the intestinal tract is associated with increased incidence of postoperative complications after bowel surgery. High fluid volume administration may prevent occult regional hypoperfusion and intestinal tissue hypoxia. We tested the hypothesis that high intraoperative fluid volume administration increases intestinal wall tissue oxygen pressure during laparotomy.

Methods

In all, 27 pigs were anaesthetized, ventilated and randomly assigned to one of the three treatment groups (n = 9 in each) receiving low (3 mL kg−1 h−1), medium (7 mL kg−1 h−1) or high (20 mL kg−1 h−1) fluid volume treatment with lactated Ringer’s solution. All animals received 30% and 100% inspired oxygen in random order. Cardiac index was measured with thermodilution and tissue oxygen pressure with a micro-oximetry system in the jejunum and colon wall and subcutaneous tissue.

Results

Groups receiving low and medium fluid volume treatment had similar systemic haemodynamics. The high fluid volume group had significantly higher mean arterial pressure, cardiac index and subcutaneous tissue oxygenation. Tissue oxygen pressures in the jejunum and colon were comparable in all three groups.

Conclusions

The three different fluid volume regimens tested did not affect tissue oxygen pressure in the jejunum and colon, suggesting efficient autoregulation of intestinal blood flow in healthy subjects undergoing uncomplicated abdominal surgery.

Keywords

PERIOPERATIVE CAREINFUSIONS INTRAVENOUSOXYGEN CONSUMPTION, gastrointestinal tract, subcutaneous
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 11 , November 2007 , pp. 927 - 933
Copyright
Copyright © European Society of Anaesthesiology 2007

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