RESUMEN
The aim of this study was to investigate the influences of acute and chronic inflammation on the dynamics of fluid shift of Ringer's solution and hemodynamics in patients during surgery. Thirty-seven patients with the American Society of Anesthesiologists (ASA) grades I-II were enrolled and allocated to two study groups according to the type of disease and operation and inflammation, including patients undergoing emergency appendectomy (Acute group, n = 19) and patients undergoing elective cholecystectomy (Chronic group, n = 18). All of the patients were administered 15 mL/kg of Ringer's lactated (LR) solution at a constant rate over 35 min before the induction of anesthesia. Plasma dilution (PD), volume expansion (VE), volume expansion efficiency (VEE), and extravascular volume (EVV) were calculated based on the concentration of hemoglobin within 2 h post-infusion. Heart rate (HR), arterial blood pressure and urine output were also recorded. PD and VE peaked at the end of infusion, while VEE peaked at the beginning of infusion in all of the patients. After infusion, PD, VE and VEE in the Acute group were all higher than those in the Chronic group (p < 0.05). PD and VE were higher during anesthesia or surgery than during awake or non-surgery (p < 0.001). The mean arterial pressure (MAP) and diastolic pressure (DBP) in the Acute group were significantly lower (p < 0.001) and HR was significantly higher (p < 0.001) than in the Chronic group during the study periods. It was suggested that patients with acute inflammation be treated with individualized fluid therapy during surgery.
Asunto(s)
Procedimientos Quirúrgicos Electivos/efectos adversos , Fluidoterapia/métodos , Inflamación/complicaciones , Complicaciones Intraoperatorias/prevención & control , Solución de Ringer/farmacocinética , Adolescente , Adulto , Apendicectomía/efectos adversos , Apendicectomía/métodos , Presión Arterial/inmunología , Colecistectomía Laparoscópica/efectos adversos , Colecistectomía Laparoscópica/métodos , Enfermedad Crónica , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Transferencias de Fluidos Corporales/inmunología , Frecuencia Cardíaca/inmunología , Humanos , Inflamación/inmunología , Complicaciones Intraoperatorias/diagnóstico , Complicaciones Intraoperatorias/inmunología , Masculino , Persona de Mediana Edad , Monitoreo Intraoperatorio , Solución de Ringer/administración & dosificación , Resultado del Tratamiento , Adulto JovenRESUMEN
The effects of long-term spaceflight on inflammatory responses have not been well-studied in either humans or animals. It is thus important to determine if the functions of immune and inflammatory cells are altered in models of spaceflight. One such animal model is antiorthostatic suspension (AOS), in which the experimental animal is subjected to a head-down tilt that mimics both the stress and the cephalad fluid shift experienced in spaceflight. A previous study reported that the peritoneal neutrophils from mice experiencing AOS generated less superoxide than unsuspended controls. We expanded on this study using several different stimuli and measuring the oxidative response of murine neutrophils in a variety of ways. These responses included the rate, lag period, and dose/response characteristics for superoxide generation, FACS analysis with dihydrodichlorofluorescein as a substrate, and a chemiluminescence response with luminol as a substrate. We also examined phagocytosis of three different microorganisms. While some effects of orthostatic suspension (attributable to the stress of the apparatus) were observed, no clear effects of AOS on oxidative function of the peritoneal neutrophils were seen.