Fluid and electrolyte balance after major thoracic surgery by bioimpedance and endocrine evaluation

Abstract

The three methods used consistently showed a significant fluid retention over the course of the study. BIA was an easy, reproducible and non-invasive method for the estimation and early detection of fluid retention. Increase in BNP may be related to the systemic reaction to stress and to the decreased pulmonary vascular bed. We found no correlation between fluid retention and length of anaesthesia, sex, age, blood loss and body mass index. The clinical and prognostic implication of weight gain may be relevant to patient's health.

Bioimpedance Spectroscopy for Assessment of Volume Status in Patients before and after General Anaesthesia

“…TBV and ECV are predicted on the basis of the primary BIA results (reactance and resistance), and ICV is calculated as the difference between TBV and ECV. SF-BIA has previously been used to detect postoperative fluid retention after major thoracic surgery [26], while MF-BIA using 4 frequencies has been employed to monitor fluid shifts after major abdominal surgery [27].…”

The Acute Stress Reaction to Major Thoracic Surgery

“…Fluid retention with weight gain was evident despite a negative intra-operative fluid balance, peri-operative strict fluid restriction, early mobilization and an encouraged intake of oral fluids as part of a normal diet. [3] As reported by several authors following lung resection, multiple factors such as thoracotomy, rapid fluid infusion, and manipulation of the lung result in an increase of the extravascular lung water. Fluids from the interstitial space transudate into the alveolar space severely impairing gas diffusion and facilitating the occurrence of pulmonary edema.…”

“…Furthermore this measure do not include a determination of the capillary permeability and postoperative fluid retention is reported despite fluidrestriction regime. Undoubtedly, there are other factors, not sufficiently investigated, that could cause this event [3].…”

“…But daily fluid balance may be inaccurate due to "perspiratio insensibilis", poor quantitation of oral fluid intake and/or urine collections [3].…”

Bioelectrical Impedance as a Diagnostic Factor in the Clinical Practice and Prognostic Factor for Survival in Cancer Patients: Prediction, Accuracy and Reliability

“…During the cyclic breathing process, the impedance of the pulmonary tissues changes 5% in the context of calm breathing, and up to 300% when inhaling from residual volume to total lung capacity [33]. One of the most attractive applications of bioimpedance characterization is cancer detection [34][35][36][37][38][39]. Hence, there are vast majority physiological differences in tumor tissues, thus BIA is efficiently applicable method for monitoring and distinguish normal healthy and tumor tissues.…”