This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Suzuki, A. Articles by Matsuki, A. Search for Related Content PubMed PubMed Citation Articles by Suzuki, A. Articles by Matsuki, A. Related Collections Cardiovascular Blood Resuscitation

---

CARDIOVASCULAR ANESTHESIA

Can Initial Distribution Volume of Glucose Predict Hypovolemic Hypotension After Radical Surgery for Esophageal Cancer?

Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki, Japan

Address correspondence and reprint requests to H. Ishihara, MD, Department of Anesthesiology, University of Hirosaki, School of Medicine, 5-Zaifu-Cho, Hirosaki-Shi, 036-8562, Japan. Address e-mail to ishihara{at}cc.hirosaki-u.ac.jp

We recently reported that the initial distribution volume of glucose (IDVG) reliably measures the central extracellular fluid volume in the presence or absence of fluid gain or loss. We examined which variables, including IDVG, can predict subsequent hypovolemic hypotension produced by the continuous shift of the extracellular fluid from the central to the peripheral compartment early after radical surgery for esophageal cancer. IDVG and plasma volume were calculated after measuring cardiac index (CI), central venous pressure, and pulmonary artery wedge pressure immediately after admission to the intensive care unit. Intraoperative fluid balance and urine volume were also recorded. Postoperative hypovolemic hypotension was clinically defined as systolic blood pressure < 80 mm Hg responsive to IV fluid administration. Either IDVG < 105 mL/kg or CI < 3.4 L · min^-1 · m^-2 was associated with subsequent hypovolemic hypotension (P = 0.002 for the former and P = 0.00 03 for the latter), while remaining variables were not. IDVG and CI were well correlated (r = 0.8 7, n = 25, P = 0.0001). Our results suggest that IDVG can help predict the subsequent hypovolemic hypotension early after radical surgery for esophageal cancer.

Implications: Routine cardiovascular variables immediately after major surgery cannot predict the subsequent hypovolemic hypotension produced by the shift of the extracellular fluid. Glucose dilution using glucose 5 g and a one-compartment model can predict it simply and rapidly.

This article has been cited by other articles:

				L. van Tulder, B. Michaeli, R. Chiolero, M. M. Berger, and J.-P. Revelly An Evaluation of the Initial Distribution Volume of Glucose to Assess Plasma Volume During a Fluid Challenge Anesth. Analg., October 1, 2005; 101(4): 1089 - 1093. [Abstract] [Full Text] [PDF]

				H. Ishihara, H. Nakamura, H. Okawa, Y. Yatsu, T. Tsubo, and K. Hirota Comparison of Initial Distribution Volume of Glucose and Intrathoracic Blood Volume During Hemodynamically Unstable States Early After Esophagectomy Chest, September 1, 2005; 128(3): 1713 - 1719. [Abstract] [Full Text] [PDF]

				H. Ishihara, H. Okawa, T. Iwakawa, N. Umegaki, T. Tsubo, and A. Matsuki Does Indocyanine Green Accurately Measure Plasma Volume Early After Cardiac Surgery? Anesth. Analg., April 1, 2002; 94(4): 781 - 786. [Abstract] [Full Text] [PDF]