An audit of fluid and heparin administration during interventional neuroradiologic procedures.
Vascular lesions of the brain such as aneurysms and arteriovenous malformations are increasingly being treated by radiologists. They use heparinized saline in pressurized bags to flush the catheter systems continuously. This fluid could have detrimental effects if the volume infused is high. Therefore, we measured the amount of heparinized saline used by radiologists and tried to assess its significance. Data were collected from the first 50 patients who underwent interventional treatment during September to December 2004. Fluid and heparin, administered by both the radiologists and anesthesiologists, were recorded in addition to demographics and postoperative complications. The mean age of patients was 49+/-14 years. The average volume of fluid given by the radiologists was 980+/-480 mL. The anesthesiologists administered an average of 1500 mL crystalloids and 650 mL of colloids. The overall fluid balance at the end of procedure was positive by 2122+/-947 mL. The amount of heparin administered by flush solution was a mean of 2500+/-1200 IU. The total amount of fluid administered had no relation to the development of vasospasm or infection. However, a statistically nonsignificant (P=0.15) 30% increase in total fluid administered to patients, who required postoperative mechanical ventilation, suggests that the relationship between fluid administration and postoperative mechanical ventilation should be investigated further in patients who undergo interventional neuroendovasular procedures. In conclusion, radiologists administer significant amount of fluid and heparin during interventional procedures. Routine recording and monitoring of all fluid and heparin administered is advisable in interventional neuroendovasular procedures. The relationship between fluid administration and postoperative mechanical ventilation should be investigated further in patients who undergo interventional neuroendovasular procedures.
Ramesh
Venkatapura J
VJ
Department of Neuroanaesthesia, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK. ramvjreddy@rediffmail.com
Tweedie
Ian
I
Sacha
Niven
N
D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging*; D003422:Critical Care; D000077324:Crystalloid Solutions; D005260:Female; D005440:Fluid Therapy / Q000706:statistics & numerical data*; D006493:Heparin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery; D007552:Isotonic Solutions / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010952:Plasma Substitutes / Q000627:therapeutic use; D011446:Prospective Studies; D011859:Radiography; D012121:Respiration, Artificial; D014882:Water-Electrolyte Balance
D000925:Anticoagulants; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D006493:Heparin