Dilution of Blood Proteins due to Irrigant Absorption in Transurethral Prostatic Resection

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Abstract
The serum concentrations of albumin, transferrin, IgG, IgM and sodium, the blood haemoglobin concentration (B-Hb) and the blood loss were determined for 10-min periods in the course of 16 transurethral prostatic resections in which irrigant absorption of between 0.5 and 2.8 1 had been measured volumetrically. The concentrations during resection, expressed as a percentage of those recorded just before induction of anaesthesia, were: B-Hb 89.2%, S-al-bumin 81.0%, S-transferrin 78.4%, S-IgG 81.0%, S-IgM 80.5% and S-Na 96.5%. The blood loss was the most important predictor of the decrease in B-Hb. The dilution of serum proteins was primarily due to hydration from crystalloid fluid given intravenously and from absorbed irrigating fluid; the most specific indicator of the degree of irrigant absorption was the serum sodium level.