scholarly journals Measurement of fluid volume using dilution volumetry in critically ill patients.

1999 ◽  
Vol 6 (4) ◽  
pp. 347-355
Author(s):  
Hironori Ishihara
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Fluid Volume

scholarly journals The contribution of plasma urea to total osmolality during iatrogenic fluid reduction in critically ill patients

Function ◽  
2021 ◽  
Author(s):  
Sandra Nihlén ◽  
Robert Frithiof ◽  
Jens Titze ◽  
Rafael Kawati ◽  
Johan Rasmusson ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Body Fluid ◽  
Plasma Osmolality ◽  
Body Water ◽  
Fluid Volume ◽  
Volume Reduction ◽  
Icu Patients ◽  
Nitrogen Intake ◽  
Body Fluid Volume

Abstract Hyperosmolality is common in critically ill patients during body fluid volume reduction. It is unknown whether this is only a result of decreased total body water, or an active osmole-producing mechanism similar to that in aestivating animals where muscle degradation increases urea levels to preserve water. We hypothesized that fluid volume reduction in critically ill patients contributes to a shift from ionic to organic osmolytes similar to mechanisms of aestivation. We performed a post-hoc analysis on data from a multicenter observational study in adult ICU patients in the post-resuscitative phase. Fluid, electrolyte, energy and nitrogen intake, fluid loss, estimated glomerular filtration rate (eGFR) and estimated plasma osmolality (eOSM) were registered. Contributions of osmolytes Na+, K+, urea and glucose to eOSM expressed as proportions of eOSM were calculated. 241 patients were included. eOSM increased (median change 7.4 mOsm/kg (IQR −1.9–18) during the study. The of sodium's and potassium's proportions of eOSM decreased (P < 0.05 and P < 0.01 respectively), whereas the urea's proportion increased (P < 0.001). Urea's proportion of eOSM was higher in patients with negative vs. positive fluid balance. The urea's proportion of eOSM increased with eOSM (r = 0.63; adjusted for eGFR r = 0.80), but not nitrogen intake. In patients without furosemide and/or renal replacement therapy (n = 17), urea's proportion of eOSM and eOSM correlated strongly (r = 0.92). Urea's proportion of eOsm was higher in patients not surviving to 90 days. In stabilized ICU patients the contribution of urea to plasma osmolality increased during body water volume reduction, statistically independently of nitrogen administration and eGFR. The shift from ionic osmolytes to urea during body fluid volume reduction is similar to that seen in aestivating animals. ClinicalTrials.org Identifier: NCT03972475

REPRODUCIBILITY OF PLASMA AND EXTRACELLULAR FLUID VOLUME MEASUREMENTS IN CRITICALLY ILL PATIENTS

1991 ◽  
Vol 16 (9) ◽  
pp. 719
Author(s):  
P. Ernest ◽  
C. D. Deane ◽  
N. G. Hartman ◽  
K. F. Cunningham ◽  
A. S. Belzberg ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Volume Measurements
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