IFAD 2013

1. P10: Intraoperative crystalloids therapy increases
intra-abdominal pressure and extravascular water
content, but not intracellular water content – pilot
study
Edyta Kotlinska-Hasiec, Michal Kowalczyk, Ziemowit Rzecki,
Wojciech Dabrowski
Department of Anaesthesiology and Intensive Therapy Medical
University of Lublin, Poland

2. Introduction
Intraabdominal pressure (IAP) is a pressure in
peritoneal cavity (0 – 7 mmHg)
 IAP > 12 mmHg – intraabdominal hypertension
 massive fluid resuscitation (more than 3,5 l of colloids and
crystalloids per 24 h)
 crystalloids is used as the main intraoperative therapy in
patients undergoing spinal anaesthesia,
 the uncontrolled infusion of crystalloids may affect tissue
oedema leading to an increase in intra-abdominal pressure
(IAP).

3. The aim of the present study was to analyse the
effect of crystalloids infusion on body water
content and IAP

4. Patients and methods:
 adult patients undergoing orthopaedic surgery under spinal anaesthesia
 IAP measured in the urinary bladder.
 IAP, total body water content (TBW), extracellular water content (ECW)
and intracellular water content (ICW) were measured using whole body
bioimpedance
 all parameters were measured at four time points:
1/ just before anaesthesia (baseline),
2/ just after surgery completion,
3/ three hours after surgery completion,
4/ on the morning of the postoperative day 1.
 spinal anaesthesia related perioperative hypotension was treated with
crystalloids infusion and in patients not responding adequately to
crystalloids infusion, a single intravenous dose of ephedrine hydrochloride
(Ephedrini, Polfa, Pl) was used.
 patients, who required colloids or blood infusion were excluded.

5. Results:
 forty patients (3 female and 37 male) aged 19 – 81
 the early postoperative period was uneventful and massive fluid
resuscitation was not necessary in the early postoperative period,
 the mean intraoperative crystalloids volume was 3135 ± 1650 mL
 the mean postoperative fluid balance was 2823 ± 3046 mL,
 the mean duration of anaestesia was 172 ± 103 min,

6. Results:

7. Results:

8. Results:

9. Conclusions
Intraoperative crystalloids infusion
increases IAP, TBW and ECW but does not
affect ICW,
3000 mL of crystalloids (41 mL/kg body
weight/3 hours) affected IAP, TBW and
ECW.