Extracellular fluid deficit following operation and its correction with Ringer's lactate. A reassessment.
The changes in extracellular fluid volume (ECV) in two groups of surgical patients, one receiving Ringer's lactate solution intraoperatively and the other receiving only dextrose and water, were assessed. A deficit in the ECV, as measured by radioactive sulfate, of 1.9 +/- 0.8 l (p less than 0.003) compared to the preoperative volume was found in the dextrose group. This was accompanied by a decrease in the mean creatinine clearance (-13% p less than 0.01), the mean urinary sodium excretion (-57% p less than 0.05), and the mean rate of clearance of the sulfate tracer (-18% p less than 0.01). The use of intraoperative Ringer's lactate (1660 cc +/- 96 cc) resulted in no change in the ECV, an increase in the mean creatinine clearance (+10% p less than 0.05), and no change in sodium excretion or tracer clearance. As a result of these findings, it appears that postoperative sodium retention is a physiologic response to a decreased ECV, which can be prevented by the administration of Ringer's lactate.
D000328:Adult; D000368:Aged; D005110:Extracellular Space / Q000378:metabolism*; D005440:Fluid Therapy; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007430:Intraoperative Care; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008875:Middle Aged; D009318:Natriuresis; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D000077325:Ringer's Lactate; D012964:Sodium / Q000378:metabolism* / Q000502:physiology; D014883:Water-Electrolyte Imbalance / Q000209:etiology* / Q000517:prevention & control
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012964:Sodium; D005947:Glucose