Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta
Background/Aim. Decreasing of arterial flow below the critical level leads to capillary endothelium edema and to further worsening of tissue perfusion. Hypertonic solution infusion provides mild and short plasma osmolality increasing, while colloidal solutions intensify that effect. The aim of this...
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2007-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500710685S.pdf |
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| author | Šoškić Ljiljana Davidović Lazar Miličić Biljana Kočica Mladen Kovačević Nataša Simić Tijana |
| author_facet | Šoškić Ljiljana Davidović Lazar Miličić Biljana Kočica Mladen Kovačević Nataša Simić Tijana |
| author_sort | Šoškić Ljiljana |
| collection | DOAJ |
| description | Background/Aim. Decreasing of arterial flow below the critical level leads to capillary endothelium edema and to further worsening of tissue perfusion. Hypertonic solution infusion provides mild and short plasma osmolality increasing, while colloidal solutions intensify that effect. The aim of this study was to investigate the effect of hypertonic-hyperoncotic solution (HH) on the organs perfusion during reconstructive surgical procedure on the abdominal aorta (AA). Methods. The study included 40 patients submitted to AA reconstruction due to aneurysm or Leriche’s syndrome. A clamp was put transversally to the aorta, under the outlets of the renal arterias. According to the solution received when a clamp was on the aorta, the patients were divided into two groups containing 20 patients each: the tested group (A) which received 4 ml/kg of the solution (7.2% NaCl/10% dextran), and the control group (B) which received 0.9% NaCl. The study excluded the patients with the preoperative creatinine level more than 139 μmol/l, and ejection heart fraction less than 40%. Results. The mixed venous blood oxygen saturation increased from 73.3±7.33 to 74.95±6.19% in the group A, while it decreased from 65.35±10.39 to 62.65±10.42% in the group B (p = 0.001). The quantity of the provided oxygen in the group A increased significantly from 684.44±244.34 to 1362.45±2351.01 ml/min, while it decreased from 668.2±382.12 to 651.7±313.98 ml/min in the group B (p = 0.016). Alveolo-arterial difference in oxygen decreased from 23.12±14.74 to 21.1±10 mmHg in the group A, while it increased from 23.79±15.22 to 26.33±13.78 mmHg in the group B (p = 0.05). Conclusion. Satisfactory perfusion of organs during the AA surgery is obtained by using both HH and an isotonic solution. Due to maintaining the optimal values of the minute heart volume, saturation of vein blood blended with oxygen, and alveoli- arterial difference in oxygen, it is recommended to use HH solution for reanimation of patients in declamping shock. |
| first_indexed | 2024-12-14T11:49:04Z |
| format | Article |
| id | doaj.art-ef58aab31c564975afcf0653c869a204 |
| institution | Directory Open Access Journal |
| issn | 0042-8450 |
| language | English |
| last_indexed | 2024-12-14T11:49:04Z |
| publishDate | 2007-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-ef58aab31c564975afcf0653c869a2042022-12-21T23:02:26ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502007-01-01641068568910.2298/VSP0710685SEffect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aortaŠoškić LjiljanaDavidović LazarMiličić BiljanaKočica MladenKovačević NatašaSimić TijanaBackground/Aim. Decreasing of arterial flow below the critical level leads to capillary endothelium edema and to further worsening of tissue perfusion. Hypertonic solution infusion provides mild and short plasma osmolality increasing, while colloidal solutions intensify that effect. The aim of this study was to investigate the effect of hypertonic-hyperoncotic solution (HH) on the organs perfusion during reconstructive surgical procedure on the abdominal aorta (AA). Methods. The study included 40 patients submitted to AA reconstruction due to aneurysm or Leriche’s syndrome. A clamp was put transversally to the aorta, under the outlets of the renal arterias. According to the solution received when a clamp was on the aorta, the patients were divided into two groups containing 20 patients each: the tested group (A) which received 4 ml/kg of the solution (7.2% NaCl/10% dextran), and the control group (B) which received 0.9% NaCl. The study excluded the patients with the preoperative creatinine level more than 139 μmol/l, and ejection heart fraction less than 40%. Results. The mixed venous blood oxygen saturation increased from 73.3±7.33 to 74.95±6.19% in the group A, while it decreased from 65.35±10.39 to 62.65±10.42% in the group B (p = 0.001). The quantity of the provided oxygen in the group A increased significantly from 684.44±244.34 to 1362.45±2351.01 ml/min, while it decreased from 668.2±382.12 to 651.7±313.98 ml/min in the group B (p = 0.016). Alveolo-arterial difference in oxygen decreased from 23.12±14.74 to 21.1±10 mmHg in the group A, while it increased from 23.79±15.22 to 26.33±13.78 mmHg in the group B (p = 0.05). Conclusion. Satisfactory perfusion of organs during the AA surgery is obtained by using both HH and an isotonic solution. Due to maintaining the optimal values of the minute heart volume, saturation of vein blood blended with oxygen, and alveoli- arterial difference in oxygen, it is recommended to use HH solution for reanimation of patients in declamping shock.http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500710685S.pdfaortaabdominalreconstructive surgical proceduresfluid therapyinfusionsparenteralsaline solutionhypertonicdextrans |
| spellingShingle | Šoškić Ljiljana Davidović Lazar Miličić Biljana Kočica Mladen Kovačević Nataša Simić Tijana Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta Vojnosanitetski Pregled aorta abdominal reconstructive surgical procedures fluid therapy infusions parenteral saline solution hypertonic dextrans |
| title | Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta |
| title_full | Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta |
| title_fullStr | Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta |
| title_full_unstemmed | Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta |
| title_short | Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta |
| title_sort | effect of hypertonic hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta |
| topic | aorta abdominal reconstructive surgical procedures fluid therapy infusions parenteral saline solution hypertonic dextrans |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2007/0042-84500710685S.pdf |
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