Distribution of normal saline and 5% albumin infusions in septic patients
OBJECTIVETo determine the relative distribution of fluid within the extracellular fluid volume (ECFV) after infusing either normal saline or 5% albumin in septic, critically ill patients. DESIGNProspective, randomized, unblinded, interventional study. SETTINGIntensive care unit in a 450-bed, tertiar...
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| Veröffentlicht in: | Critical care medicine 1999-01, Vol.27 (1), p.46-50 |
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| creator | Ernest, David Belzberg, Allan S Dodek, Peter M |
| description | OBJECTIVETo determine the relative distribution of fluid within the extracellular fluid volume (ECFV) after infusing either normal saline or 5% albumin in septic, critically ill patients.
DESIGNProspective, randomized, unblinded, interventional study.
SETTINGIntensive care unit in a 450-bed, tertiary care, teaching hospital.
PATIENTSSeptic, critically ill patients (n = 18).
INTERVENTIONSInfusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician.
MEASUREMENTS AND MAIN RESULTSPlasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of I-albumin and S sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline increased the ECFV by approximately the volume infused, and the expansion of the PV to ISFV was in a ratio of 1:3. Infusion of 5% albumin increased the ECFV by double the volume infused, with both the PV and ISFV expanding by approximately equal amounts. Oxygen delivery index did not increase after either infusion due to the effect of hemodilution.
CONCLUSIONExpansion of the ECFV in excess of the volume of 5% albumin infused suggests that fluid may move from the intracellular fluid volume to the ECFV in septic patients who receive this fluid. (Crit Care Med 1999; 27:46-50) |
| doi_str_mv | 10.1097/00003246-199901000-00025 |
| format | Article |
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DESIGNProspective, randomized, unblinded, interventional study.
SETTINGIntensive care unit in a 450-bed, tertiary care, teaching hospital.
PATIENTSSeptic, critically ill patients (n = 18).
INTERVENTIONSInfusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician.
MEASUREMENTS AND MAIN RESULTSPlasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of I-albumin and S sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline increased the ECFV by approximately the volume infused, and the expansion of the PV to ISFV was in a ratio of 1:3. Infusion of 5% albumin increased the ECFV by double the volume infused, with both the PV and ISFV expanding by approximately equal amounts. Oxygen delivery index did not increase after either infusion due to the effect of hemodilution.
CONCLUSIONExpansion of the ECFV in excess of the volume of 5% albumin infused suggests that fluid may move from the intracellular fluid volume to the ECFV in septic patients who receive this fluid. (Crit Care Med 1999; 27:46-50)</description><identifier>ISSN: 0090-3493</identifier><identifier>EISSN: 1530-0293</identifier><identifier>DOI: 10.1097/00003246-199901000-00025</identifier><identifier>PMID: 9934892</identifier><identifier>CODEN: CCMDC7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; APACHE ; Biological and medical sciences ; Colloids - pharmacokinetics ; Critical Illness - therapy ; Crystalloid Solutions ; Emergency and intensive care: infection, septic shock ; Extracellular Space - diagnostic imaging ; Extracellular Space - metabolism ; Female ; Fluid Shifts ; Fluid Therapy ; Humans ; Intensive care medicine ; Isotonic Solutions ; Male ; Medical sciences ; Middle Aged ; Oxygen Consumption ; Plasma Substitutes - pharmacokinetics ; Plasma Volume ; Prospective Studies ; Radionuclide Imaging ; Radiopharmaceuticals ; Rehydration Solutions - pharmacokinetics ; Serum Albumin - pharmacokinetics ; Serum Albumin, Radio-Iodinated ; Shock, Septic - physiopathology ; Shock, Septic - therapy ; Sodium Chloride - pharmacokinetics ; Sulfur Radioisotopes</subject><ispartof>Critical care medicine, 1999-01, Vol.27 (1), p.46-50</ispartof><rights>1999 Lippincott Williams & Wilkins, Inc.</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3845-6e56aa62631c6479a01e8f4501887c1b9d59c358c07fd9b7f738c02cc3a9bb9f3</citedby><cites>FETCH-LOGICAL-c3845-6e56aa62631c6479a01e8f4501887c1b9d59c358c07fd9b7f738c02cc3a9bb9f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1664688$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9934892$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ernest, David</creatorcontrib><creatorcontrib>Belzberg, Allan S</creatorcontrib><creatorcontrib>Dodek, Peter M</creatorcontrib><title>Distribution of normal saline and 5% albumin infusions in septic patients</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>OBJECTIVETo determine the relative distribution of fluid within the extracellular fluid volume (ECFV) after infusing either normal saline or 5% albumin in septic, critically ill patients.
DESIGNProspective, randomized, unblinded, interventional study.
SETTINGIntensive care unit in a 450-bed, tertiary care, teaching hospital.
PATIENTSSeptic, critically ill patients (n = 18).
INTERVENTIONSInfusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician.
MEASUREMENTS AND MAIN RESULTSPlasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of I-albumin and S sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline increased the ECFV by approximately the volume infused, and the expansion of the PV to ISFV was in a ratio of 1:3. Infusion of 5% albumin increased the ECFV by double the volume infused, with both the PV and ISFV expanding by approximately equal amounts. Oxygen delivery index did not increase after either infusion due to the effect of hemodilution.
CONCLUSIONExpansion of the ECFV in excess of the volume of 5% albumin infused suggests that fluid may move from the intracellular fluid volume to the ECFV in septic patients who receive this fluid. (Crit Care Med 1999; 27:46-50)</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>APACHE</subject><subject>Biological and medical sciences</subject><subject>Colloids - pharmacokinetics</subject><subject>Critical Illness - therapy</subject><subject>Crystalloid Solutions</subject><subject>Emergency and intensive care: infection, septic shock</subject><subject>Extracellular Space - diagnostic imaging</subject><subject>Extracellular Space - metabolism</subject><subject>Female</subject><subject>Fluid Shifts</subject><subject>Fluid Therapy</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Isotonic Solutions</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Oxygen Consumption</subject><subject>Plasma Substitutes - pharmacokinetics</subject><subject>Plasma Volume</subject><subject>Prospective Studies</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>Rehydration Solutions - pharmacokinetics</subject><subject>Serum Albumin - pharmacokinetics</subject><subject>Serum Albumin, Radio-Iodinated</subject><subject>Shock, Septic - physiopathology</subject><subject>Shock, Septic - therapy</subject><subject>Sodium Chloride - pharmacokinetics</subject><subject>Sulfur Radioisotopes</subject><issn>0090-3493</issn><issn>1530-0293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1vFDEMhiMEarcLPwEph8JtSjL5mPiICrSVKnGBc5TJJmpoJrONZ1Tx7wnstpwayYotv36jPCaEcnbBGQyfWDuil7rjAMB4q7oWvXpFNlyJVvQgXpMNY8A6IUGckjPEX4xxqQZxQk4AhDTQb8jNl4RLTeO6pLnQOdIy18llii6nEqgrO6o-UJfHdUqFphJXbEJsGcWwX5Kne7ekUBZ8S95ElzG8O95b8vPb1x-X193t96uby8-3nRdGqk4HpZ3TvRbcazmAYzyYKBXjxgyej7BT4IUyng1xB-MQB9Hy3nvhYBwhii35ePDd1_lhDbjYKaEPObsS5hWtBtXc2we3xByEvs6INUS7r2ly9bflzP6laJ8o2meK9h_FNvr--MY6TmH3PHjE1vrnx75D73KsrviE__21ltqYJpMH2eOcl1DxPq-Podq74PJyZ1_aofgDiWCImQ</recordid><startdate>199901</startdate><enddate>199901</enddate><creator>Ernest, David</creator><creator>Belzberg, Allan S</creator><creator>Dodek, Peter M</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199901</creationdate><title>Distribution of normal saline and 5% albumin infusions in septic patients</title><author>Ernest, David ; Belzberg, Allan S ; Dodek, Peter M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3845-6e56aa62631c6479a01e8f4501887c1b9d59c358c07fd9b7f738c02cc3a9bb9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>APACHE</topic><topic>Biological and medical sciences</topic><topic>Colloids - pharmacokinetics</topic><topic>Critical Illness - therapy</topic><topic>Crystalloid Solutions</topic><topic>Emergency and intensive care: infection, septic shock</topic><topic>Extracellular Space - diagnostic imaging</topic><topic>Extracellular Space - metabolism</topic><topic>Female</topic><topic>Fluid Shifts</topic><topic>Fluid Therapy</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Isotonic Solutions</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Oxygen Consumption</topic><topic>Plasma Substitutes - pharmacokinetics</topic><topic>Plasma Volume</topic><topic>Prospective Studies</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>Rehydration Solutions - pharmacokinetics</topic><topic>Serum Albumin - pharmacokinetics</topic><topic>Serum Albumin, Radio-Iodinated</topic><topic>Shock, Septic - physiopathology</topic><topic>Shock, Septic - therapy</topic><topic>Sodium Chloride - pharmacokinetics</topic><topic>Sulfur Radioisotopes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ernest, David</creatorcontrib><creatorcontrib>Belzberg, Allan S</creatorcontrib><creatorcontrib>Dodek, Peter M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ernest, David</au><au>Belzberg, Allan S</au><au>Dodek, Peter M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distribution of normal saline and 5% albumin infusions in septic patients</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>1999-01</date><risdate>1999</risdate><volume>27</volume><issue>1</issue><spage>46</spage><epage>50</epage><pages>46-50</pages><issn>0090-3493</issn><eissn>1530-0293</eissn><coden>CCMDC7</coden><abstract>OBJECTIVETo determine the relative distribution of fluid within the extracellular fluid volume (ECFV) after infusing either normal saline or 5% albumin in septic, critically ill patients.
DESIGNProspective, randomized, unblinded, interventional study.
SETTINGIntensive care unit in a 450-bed, tertiary care, teaching hospital.
PATIENTSSeptic, critically ill patients (n = 18).
INTERVENTIONSInfusion of either normal saline or 5% albumin to a hemodynamic end point determined by the patient's clinician.
MEASUREMENTS AND MAIN RESULTSPlasma volume (PV), ECFV, cardiac index, and arterial oxygen content were measured immediately before (baseline) and after each fluid infusion. PV and ECFV were measured by dilution of I-albumin and S sodium sulfate, respectively. Interstitial fluid volume (ISFV) was calculated as ECFV - PV. Baseline values for PV, ISFV, ECFV, and oxygen delivery index did not differ between treatment groups. Infusion of normal saline increased the ECFV by approximately the volume infused, and the expansion of the PV to ISFV was in a ratio of 1:3. Infusion of 5% albumin increased the ECFV by double the volume infused, with both the PV and ISFV expanding by approximately equal amounts. Oxygen delivery index did not increase after either infusion due to the effect of hemodilution.
CONCLUSIONExpansion of the ECFV in excess of the volume of 5% albumin infused suggests that fluid may move from the intracellular fluid volume to the ECFV in septic patients who receive this fluid. (Crit Care Med 1999; 27:46-50)</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>9934892</pmid><doi>10.1097/00003246-199901000-00025</doi><tpages>5</tpages></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy APACHE Biological and medical sciences Colloids - pharmacokinetics Critical Illness - therapy Crystalloid Solutions Emergency and intensive care: infection, septic shock Extracellular Space - diagnostic imaging Extracellular Space - metabolism Female Fluid Shifts Fluid Therapy Humans Intensive care medicine Isotonic Solutions Male Medical sciences Middle Aged Oxygen Consumption Plasma Substitutes - pharmacokinetics Plasma Volume Prospective Studies Radionuclide Imaging Radiopharmaceuticals Rehydration Solutions - pharmacokinetics Serum Albumin - pharmacokinetics Serum Albumin, Radio-Iodinated Shock, Septic - physiopathology Shock, Septic - therapy Sodium Chloride - pharmacokinetics Sulfur Radioisotopes |
| title | Distribution of normal saline and 5% albumin infusions in septic patients |
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