Ringer's lactate with or without 3% dextran-60 as volume expanders during abdominal aortic surgery

I. J A Dawidson, C. D. Willms, Z. F. Sandor, L. L. Coorpender, J. S. Reisch, W. J. Fry

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Objective: To compare a solution of 3% dextran-60 (D60) in Ringer's lactate (RL) with RL alone as maintenance fluids for abdominal aortic surgery. Design: Randomized control trial of 20 consecutive patients undergoing elective aortic reconstructive surgery. Setting: A surgical ICU in a university hospital. Patients: Consecutive patients, mean age 64 yr. Five patients had abdominal aneurysm, 12 had aortic obstruction disease, and three had aortic renal bypass surgery. These patients were followed for 1 month. Interventions: Pulmonary artery occlusion pressure of at least 10 mm Hg and a urine output >30 mL/h were used to guide the intraoperative fluid infusion rates, which were 36 and 104 mL/kg of D60 and RL, respectively (ratio 1:2.9). Measurements and Main Results: Body weight at 24 hr had increased more with RL (7.8 kg) than with D60 (3.2 kg) infusion (p < .01), despite intraoperative urine volumes of 151 and 92 mg/kg with RL and D60, respectively. Total intravascular albumin decreased from 0.7 g/kg (1.4 to 0.7 g/kg) in both groups, corresponding to a plasma volume (PV) loss of 13 mg/kg without fluid infusions. A total intravascular dextran of 0.5 g/kg resulted in a PV expansion at 1 hr of 4.4 mL/kg above preoperative level, in sharp contrast to 7.0 mL/kg decrease in PV with RL. Of the intraoperative 3% D60 and RL infused, an estimated 51% D60 and 6% RL remained as PV expansion at 1 hr. Conclusions: A diluted colloid solution in Ringer's lactate is of significant value in maintaining intravascular volumes and hemodynamics during and after major operative procedures.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalCritical care medicine
Volume19
Issue number1
DOIs
StatePublished - Jan 1 1991

Keywords

  • Aortic surgery
  • Blood volume
  • Colloid
  • Dextran
  • Fluid therapy
  • Hemodynamics
  • Infusions, intravenous
  • Plasma volume
  • Pulmonary artery wedge pressure
  • Ringer's lactate

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Ringer's lactate with or without 3% dextran-60 as volume expanders during abdominal aortic surgery'. Together they form a unique fingerprint.

  • Cite this