Fluid Shifts during the Surgical Period

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Abstract
Three groups of 6 patients each and 1 of 7 undergoing elective cholecystectomy were given the same type of anesthesia during operation. Group 1 received only enough fluid to maintain an open infusion route; Groups 2, 3 and 4 received 15 ml/kg the first hour and 7.5 ml/kg each hour thereafter of 5% glucose (this group includes 7 patients), lactate Ringers solution, and physiologic salt solution, respectively. Pre- and post-operative blood volumes and FECFV [functional extracellular fluid volume] were determined using RISA [radioiodinated serum albumin] and Na2S35O4. Patients were weighed daily and immediately pre- and postoperatively. Intake and output of fluid, Na, K and chloride were determined, and insensible loss was measured by difference in weight. Patients lost weight consistently at each weighing except during the operative period when Groups 2, 3 and 4 had large infusions of fluid. All patients gained a little during the time from the end of operation until the next morning, all receiving fairly large quantities of fluids intravenously. During the operative period, in spite of infusions, fluid moved from tissue spaces or cells which greatly increased the quantity of FECF. The average amount of such shift from tissue spaces was less when lactated Ringers solution was used. The differences were not statistically significant. Insensible loss was approximately 150 ml/hr during the operative period.