Perioperative fluid management: comparison of high, medium and low fluid volume on tissue oxygen pressure in the small bowel and colon.
OBJECTIVE
Insufficient blood flow and oxygenation in the intestinal tract is associated with increased incidence of postoperative complications after bowel surgery. High fluid volume administration may prevent occult regional hypoperfusion and intestinal tissue hypoxia. We tested the hypothesis that high intraoperative fluid volume administration increases intestinal wall tissue oxygen pressure during laparotomy.


METHODS
In all, 27 pigs were anaesthetized, ventilated and randomly assigned to one of the three treatment groups (n = 9 in each) receiving low (3 mL kg-1 h-1), medium (7 mL kg-1 h-1) or high (20 mL kg-1 h-1) fluid volume treatment with lactated Ringer's solution. All animals received 30% and 100% inspired oxygen in random order. Cardiac index was measured with thermodilution and tissue oxygen pressure with a micro-oximetry system in the jejunum and colon wall and subcutaneous tissue.


RESULTS
Groups receiving low and medium fluid volume treatment had similar systemic haemodynamics. The high fluid volume group had significantly higher mean arterial pressure, cardiac index and subcutaneous tissue oxygenation. Tissue oxygen pressures in the jejunum and colon were comparable in all three groups.


CONCLUSIONS
The three different fluid volume regimens tested did not affect tissue oxygen pressure in the jejunum and colon, suggesting efficient autoregulation of intestinal blood flow in healthy subjects undergoing uncomplicated abdominal surgery.
Hiltebrand
L B
LB
Washington University, Department of Anesthesiology, St. Louis, MO, USA. luzius.hiltebrand@insel.ch
Pestel
G
G
Hager
H
H
Ratnaraj
J
J
Sigurdsson
G H
GH
Kurz
A
A
D000818:Animals; D001810:Blood Volume / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D003106:Colon / Q000378:metabolism*; D000077324:Crystalloid Solutions; D005440:Fluid Therapy; D006863:Hydrogen-Ion Concentration; D020896:Hypovolemia / Q000517:prevention & control; D007421:Intestine, Small / Q000378:metabolism*; D007552:Isotonic Solutions / Q000008:administration & dosage; D007813:Laparotomy; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000502:physiology; D019990:Perioperative Care; D010952:Plasma Substitutes / Q000008:administration & dosage; D015656:Respiratory Mechanics / Q000502:physiology; D013552:Swine
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D002245:Carbon Dioxide; D010100:Oxygen