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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Cholecystectomy, Colloids, Female, Humans, Hydroxyethyl Starch Derivatives, Infusions, Intravenous, Intraoperative Care, Kinetics, Lactic Acid, Laparoscopy, Male, Middle Aged, Postoperative Period.
user
Does intra-operative colloid administration increase the clearance of a post-operative fluid load? Context: It is unknown whether an intra-operative colloid infusion alters the dynamics of a crystalloid load administered post-operatively. Ten patients received 12.5 ml/kg of Ringer's lactate over 30 min 1-3 days before and 4 h after laparoscopic cholecystectomy, during which 10 ml/kg of a colloid solution, hydroxyethylstarch (HES 130/0.4), was infused. The total body clearance of the pre- and post-operative test infusions was taken as the ratio between the urinary excretion and the Hb-derived dilution of venous plasma over 150 min. The plasma clearance of the infused fluid was calculated using volume kinetics based on the plasma dilution alone. The pre-operative plasma clearance was compared with the post-operative plasma clearance and patients served as their own control. The urinary excretion averaged 350 ml for the pre-operative infusion and 612 ml post-operatively, which corresponds to 46% and 68% of the pre- and post-operative infusions, respectively. The total body clearance of the crystalloid fluid was 30 ml/min before surgery and 124 ml/min after surgery (P<0.01). The plasma clearance, as obtained from the plasma dilution alone, was 28 and 412 ml/min, respectively. The maximal increase in plasma volume was 410 ml pre-operatively vs. 220 ml post-operatively.
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Infusion of a colloid solution in combination with a crystalloid during laparoscopic cholecystectomy increased the plasma clearance of a post-operative crystalloid infusion. Final Decision: yes