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The Journal of Cardiovascular Surgery 2000 August;41(4):559-66

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Evaluation of body fluid status after cardiac surgery using bioelectrical impedance analysis

Yamaguchi H., Yamauchi H., Hazama S., Hamamoto H.

From the Department of Cardiovascular Surgery Nagasaki University School of Medicine, Nagasaki, Japan and *Oita Prefectural Hospital, Oita, Japan


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Back­ground. In the assess­ment of ­fluid ­status ­after car­diac sur­gery, we ­applied bio­electrical impe­dance anal­ysis (BIA) to ­measure the ­total ­body ­water (TBW), extra­cel­lular ­fluid (ECF), and intra­cel­lular ­fluid (ICF), and eval­u­ated its ­validity.
­Methods. ­Thirty ­patients who under­went car­di­o­pul­mo­nary ­bypass (CPB ­group) and 19 sur­gical ­patients not ­receiving CPB (non-CPB ­group).
­Results. The ­change of BIA ­values (­ΔTBW, ­ΔECF, ­ΔICF), ­body ­weight and cumu­la­tive ­fluid bal­ance ­were deter­mined for 120 post­op­er­a­tive ­hours, and the rela­tion­ship ­between BIA ­values and ­body ­weight and ­fluid bal­ance ­were eval­u­ated. Post­op­er­a­tive ­changes in BIA ­values in the CPB ­group ­were com­pared ­with ­those in the non-CPB ­group. ­Finally the ECF/ICF ­ratio and hemo­dy­namic param­e­ters ­were com­pared. ­ΔTBW and ­ΔECF cor­re­lated ­with ­changes in ­body ­weight and ­fluid bal­ance, respec­tively. Espe­cially ­there was a ­high cor­re­la­tion in ­each ­case ­although ­large devi­a­tions in the ­slope of the regres­sion ­lines ­were ­observed. TBW and ECF ­increased ­from imme­di­ately ­after oper­a­tion up to 96 ­hours (the max­imum ­value was at day 2). On the ­other ­hand, ICF ­decreased ­from 48 to 72 ­hours ­after oper­a­tion. ­There ­were sig­nif­i­cant ­high ECF/ICF in the CPB ­group com­pared ­with the non-CPB ­group ­from 12 to 72 post­op­er­a­tive ­hours. We ­found ­that ECF/ICF cor­re­lated ­inversely ­with ­mean ­blood pres­sure, ­mixed ­venous ­oxygen sat­u­ra­tion and col­loid ­osmotic pres­sure, and pos­i­tively ­with cen­tral ­venous pres­sure and pul­mo­nary ­artery ­wedge pres­sure.
Con­clu­sions. It was con­sid­ered ­that BIA was ­useful for eval­u­ating the rel­a­tive ­changes in TBW and ­fluid dis­tri­bu­tion, and ECF/ICF ­might be a new param­eter for ­abnormal ­water metab­olism ­after car­diac sur­gery.

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