Kinetics of Peritoneal Fluid Absorption in Adult Man

Shear, Leroy; Swartz, Charles Captain; Shinaberger, James A. Major; Barry, Kevin G.

doi:10.1056/nejm196501212720303

Cited by 104 publications

(41 citation statements)

References 11 publications

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“…It remained constant during the second part of the dwell time. Similar observations have been reported in rabbits [22,23], dogs [24] and humans [25], As the lymphatic absorp tion is constant during a dwell [5,6], these observations can be explained by transcapil lary fluid absorption in two phases: ( 1 ) solute equilibration phase with fluid absorption in duced by both the crystalloid-and colloidosmotic gradients and (2) an absorption phase due to the colloid-osmotic gradient [24,25]. This explanation seems to be in conflict with the results of earlier experiments in which intraperitoneal isotonic solutions were com pared with heparinized plasma of humans or animals.…”

Section: Discussionsupporting

confidence: 90%

Fluid Kinetics in CAPD Patients during Dialysis with a Bicarbonate-Based Hypoosmolar Solution

Struijk¹,

Krediet²,

Imholz³

et al. 1996

Blood Purif

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The magnitude of transcapillary backfïltration by the colloid-osmotic pressure within the peritoneal capillaries compared to the effective lymphatic absorption was investigated in continuous ambulatory peritoneal dialysis patients. This was done during a 4-hour dwell period, using a hypoosmolar dialysis fluid (280 mosm/kg H₂O) in 8 patients and compared to 5 of these patients using a 1.36% glucose (GS; 324 mosm/kg H₂O). The low molecular weight solute transport did not differ between the two solutions. The intraperitoneal dextran 70 concentration increased during the dwell with the hypoosmolar dialysis fluid (from 770 to 945 mg/l; p = 0.000002) and decreased with the GS (from 859 to 719 mg/l; p = 0.007). With the GS the transcapillary ultrafiltration was directed towards the abdominal cavity during the dwell period. With the hypoosmolar fluid, the transcapillary ultrafiltration was continuously directed towards the circulation. In this solution, the magnitude of transcapillary backfiltration due to colloid-osmotic pressure within the peritoneal capillaries was 0.4 ± 0.1 ml/min. In conclusion, intraperitoneal markers can be used in continuous ambulatory peritoneal dialysis patients for determination of effective lymphatic absorption and transcapillary fluid passage in both transport directions.

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Section: Discussionsupporting

confidence: 90%

Fluid Kinetics in CAPD Patients during Dialysis with a Bicarbonate-Based Hypoosmolar Solution

Struijk¹,

Krediet²,

Imholz³

et al. 1996

Blood Purif

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“…This compartmentalization of ascites and nonascitic edema may be related to the fact that the rates of reabsorption from the peritoneal cavity of certain fluids are limited, as compared to that of reabsorption of peripheral edema. Thus, in normal subjects, isotonic saline solution is absorbed only at a relatively slow rate of 30-37 ml/h [12], Similarly, in cirrhotic patients, the maximal rate of ascites absorption is also never more than 930 ml per day in spite of diuretic therapy [11].…”

Section: Discussionmentioning

confidence: 99%

Ascites in Patients Treated with Maintenance Hemodialysis

Wang¹,

Pillay²,

Ing³

et al. 1974

Nephron

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Eight patients treated with maintenance hemodialysis developed significant ascites. Fluid retention appears to be a common denominator. Increased capillary permeability from uremia may be a contributory factor. Compartmentalization of ascitic and nonascitic fluids is often observed. Therapeutic measures include fluid and sodium restriction, fluid removal by dialysis, abdominal paracentesis, intravenous infusion of ascitic fluid or albumin and renal transplantation. The latter appears to be the ideal therapy.

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“…There are surgeons who believe that drainage of peritoneal cavity is impossible, and therefore, prophylactic drainage is useless [15,16]. The surgeons who are opposed to drainage believe that it [17][18][19][20][21][22] (A) Actually stimulates the formation of serous fluid (B) Can lead to infection from outside (C) Increases the rate of leakage by preventing the mobilization of omentum and adjacent organs, obstructing their sealing action on suture line or even creating leakage by mechanical erosion of the anastomoses (D) Is walled off quickly Although there is a considerable theoretical and practical evidences in favor of drainage, the dispute about "to drain or not to drain" the peritoneal cavity after elective colorectal surgery remains open [23]. Anastomotic dehiscence is a serious complication leading to major mortality and morbidity of colorectal surgery [24].…”

Section: Drain Vs No Drainmentioning

confidence: 99%

To Drain or Not to Drain after Colorectal Cancer Surgery

Samaiya¹

2015

Indian J Surg

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Prophylactic drainage of abdominal cavity after GI surgery has been widely practiced. The most important signal function of prophylactic drain is to detect early complications. But the same drains could be the cause of some of the complications. Although there is a considerable theoretical and practical evidences in favor of drainage, the dispute about Bto drain or not to drain^the peritoneal cavity after elective colorectal surgery remains open. Unfortunately, the principle of drainage is not based on any scientific data. During the last three decades, surgeons have made efforts to investigate the value of prophylactic drainage after colorectal surgery. However, the results of trials are contradictory due to lack of quality and/or statistical power and therefore do not provide an answer to the clinical question. A systematic review of studies suggests that there is insufficient evidence for routine use of drain after colorectal surgery. Despite evidence-based data questioning prophylactic drainage of abdominal cavity in many instances, most surgeons around the world continue to use drains on a routine basis until now. There are strong evidences in literature in favor of no apparent benefit of drainage for supra-peritoneal anastomoses; however, there is still controversies regarding drainage of infra-peritoneal rectal anastomoses.

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Kinetics of Peritoneal Fluid Absorption in Adult Man

Cited by 104 publications

References 11 publications

Fluid Kinetics in CAPD Patients during Dialysis with a Bicarbonate-Based Hypoosmolar Solution

Fluid Kinetics in CAPD Patients during Dialysis with a Bicarbonate-Based Hypoosmolar Solution

Ascites in Patients Treated with Maintenance Hemodialysis

To Drain or Not to Drain after Colorectal Cancer Surgery

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