Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Anesthesia
Published in: Journal of Anesthesia 1/2017

01-02-2017 | Original Article

Effects of cardiac output on the initial distribution volume of glucose in the absence of fluid gain or loss in pigs

Authors: Toshinori Kasai, Eiji Hashiba, Junichi Saito, Kazuyoshi Hirota

Published in: Journal of Anesthesia | Issue 1/2017

Login to get access

Abstract

The initial distribution volume of glucose (IDVG) has been reported to be a surrogate marker of cardiac preload. However, the relationship between cardiac output and IDVG is not fully understood. We investigated the effects of cardiac output on IDVG in the absence of fluid gain or loss in pigs.

Materials and methods

Thirteen pigs were anesthetized and allocated to either the modified cardiac output group (m-CO group, n = 10) or the control group (control group, n = 3). In the m-CO group, CO was sequentially modulated from high CO (high CO) to two grades of low CO (low CO-1 and low CO-2) with dobutamine and propranolol with lidocaine, respectively, in the absence of any apparent change in basal fluid volume status. Thermodilutional CO and IDVG were measured at each CO condition. The IDVG was measured according to a one-compartment model with 2 g glucose. The same parameters were measured in the control group using the same time schedule as for the m-CO group but without inotropes and at a stable CO state. Thereafter, 250 ml of 10% dextran were infused over 15 min to compare the effects of a preload-dependent increase in CO on IDVG measurements to the effects of the pharmacological modification of CO. Data were expressed as the mean ± SD. Statistical analysis was performed with repeated measures ANOVA followed by Dunnett’s test. Pearson’s correlation test was also used. A P value of <0.05 was considered to indicate statistical significance.

Results

In the m-CO group, where CO increased to 147.2 ± 26.7% of the baseline CO value in the high CO state and decreased to 65.9 ± 11.0 and 37.3 ± 14.4% of the baseline CO value in the low CO-1 state and the low CO-2 state, respectively, the IDVG did not change as CO was modified. IDVG significantly increased in response to volume loading of dextran in the control group. There was no correlation between the IDVG and CO in the m-CO group when there was no fluid gain or loss (r = 0.097, n = 40, P = 0.554), but the IDVG was well correlated with CO in the control group with volume loading (r = 0.764, n = 18, P = 0.0002).

Conclusion

This study suggests that the IDVG is dependent on the central extracellular fluid volume and not on cardiac output.
Literature
1.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41:580–637.CrossRefPubMed
2.
3.
Magder S. Central venous pressure: a useful but not so simple measurement. Crit Care Med. 2006;34:2224–7.CrossRefPubMed
4.
Bendjelid K. Right atrial pressure: determinant or result of change in venous return? Chest. 2005;128:3639–40.CrossRefPubMed
5.
McNelis J, Marini CP, Jurkiewicz A, Fields S, Caplin D, Stein D, Ritter G, Nathan I, Simms HH. Predictive factors associated with the development of abdominal compartment syndrome in the surgical intensive care unit. Arch Surg. 2002;137:133–6.CrossRefPubMed
6.
Durairaj L, Schmidt GA. Fluid therapy in resuscitated sepsis: less is more. Chest. 2008;133:252–63.CrossRefPubMed
7.
Humphrey H, Hall J, Sznajder I, Silverstein M, Wood L. Improved survival in ARDS patients associated with a reduction in pulmonary capillary wedge pressure. Chest. 1990;97:1176–80.CrossRefPubMed
8.
Simmons RS, Berdine GG, Seidenfeld JJ, Prihoda TJ, Harris GD, Smith JD, Gilbert TJ, Mota E, Johanson WG Jr. Fluid balance and the adult respiratory distress syndrome. Am Rev Respir Dis. 1987;135:924–9.CrossRefPubMed
9.
Alsous F, Khamiees M, DeGirolamo A, Amoateng-Adjepong Y, Manthous CA. Negative fluid balance predicts survival in patients with septic shock: a retrospective pilot study. Chest. 2000;117:1749–54.CrossRefPubMed
10.
Ishihara H, Giesecke AH. Fluid volume monitoring with glucose dilution. Tokyo: Springer; 2007.
11.
Takamura K, Iwakawa T, Sakai I, Muraoka M, Ishihara H, Matsuki A. Comparison of the initial distribution of glucose and sucrose in volume-challenged dogs. Infus Ther Transfus Med. 1997;24:144–50.
12.
Shimodate Y, Ishihara H, Matsuki A. The initial distribution volume of glucose and cardiac output after haemorrhage in dogs. Can J Aneasth. 1994;41:257–60.CrossRef
13.
Iwakawa T, Ishihara H, Takamura K, Sakai I, Suzuki A. Measurements of extracellular fluid volume in highly perfused organs and lung water in hypo- and hypervolaemic dogs. Eur J Anaesthesiol. 1998;15:414–21.CrossRefPubMed
14.
Ishihara H, Shimodate Y, Koh H, Isozaki K, Tsubo T, Matsuki A. The initial distribution volume of glucose and cardiac output in the critically ill. Can J Anaesth. 1993;40:28–31.CrossRefPubMed
15.
Ishihara H, Suzuki A, Okawa H, Sakai I, Tsubo T, Matsuki A. The initial distribution volume of glucose rather than indocyanine green derived plasma volume is correlated with cardiac output following major surgery. Intensive Care Med. 2000;26:1441–8.CrossRefPubMed
16.
Orban JC, Blasin-Chadoutaud A, Zolfaghari P, Ishihara H, Grimaud D, Ichai C. Hypovolaemic hypotension after abdominal aortic surgery is predicted by initial distribution volume of glucose. Eur J Anaesthesiol. 2010;27:364–8.CrossRefPubMed
17.
He Z, Qiao H, Zhou W, Wang Y, Xu Z, Che X, Zhang J, Liang W. Assessment of cardiac preload status by pulse pressure variation in patients after anesthesia induction: comparison with central venous pressure and initial distribution volume of glucose. J Anesth. 2011;25(6):812–7.CrossRefPubMed
18.
Lu W, Dong J, Xu Z, Shen H, Zheng J. The Pleth variability index as an indicator of the central extracellular fluid volume in mechanically ventilated patients after anesthesia induction: comparison with initial distribution volume of glucose. Med Sci Monit. 2014;8(20):386–92.
19.
Ishihara H, Takamura K, Koh H, Iwakawa T, Tsubo T, Matsuki A. Does the initial distribution volume of glucose reflect the central extracellular fluid volume status in critically ill patients? Infus Ther Transfus Med. 1996;23:196–201.
20.
Saito J, Ishihara H, Hashiba E, Okawa H, Kudo T, Sawada M, Tsubo T, Hirota K. Corrected right ventricular end-diastolic volume and initial distribution volume of glucose correlate with cardiac output after cardiac surgery. J Anesth. 2013;27:512–20.CrossRefPubMed
21.
Hashiba E, Ishihara H, Tsubo T, Okawa H, Hirota K. Use of initial distribution volume of glucose to determine fluid volume loading in pulmonary thromboembolism and right ventricular myocardial infarction. J Anesth. 2008;22:453–6.CrossRefPubMed
22.
Rose BO, Ishihara H, Okawa H, Panning B, Piepenbrock S, Matsuki A. Repeatability of measurements of the initial distribution volume of glucose in haemodynamically stable patients. J Clin Pharm Ther. 2004;29:317–23.CrossRefPubMed
23.
Akaike H. A new look at the statistical model identification. IEEE Trans Automat Control. 1974;AC-19:716–23.CrossRef
24.
Koh H, Ishihara H, Miyahara A, Takahashi S, Matsuki A. Does the initial distribution volume of glucose reflect plasma volume after haemorrhage in dogs? Can J Anaesth. 1995;42:163–7.CrossRefPubMed
25.
Miyahara A, Ohkawa H, Ishihara H, Matsuki A. Changes in the initial distribution volume of glucose and plasma volume following volume challenge in dogs. Infus Ther Transfus Med. 1995;22:274–9.
26.
Ghoneim M, Pearson K. Pharmacokinetics of drugs administered intravenously. In: Scurr C, Soni Feldman N, Feldman S, editors. Scientific foundations of anaesthesia: the basis of intensive care. 4th ed. Chicago: Year Book Medical Publishers; 1990. p. 559–71.
27.
Wilkinson GR. Pharmacokinetics: the dynamics of drug absorption, disposition and elimination. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 10th ed. New York: McGraw Hill; 2001. p. 20–2.
28.
Hall JE. The microcirculation and lymphatic system; capillary fluid exchange, interstitial fluid, and lymph flow. In: Guyton and Hall textbook of medical physiology. 12th ed. Philadelphia: Elsevier; 2011. p. 179–80.
29.
Finnerty FA Jr, Buchholz JH, Guillaudeu RL. The blood volumes and plasma protein during levarterenol-induced hypertension. J Clin Invest. 1958;37:425–9.CrossRefPubMedPubMedCentral
30.
Ring C, Patterson SM, Bacon SL, Veldhuijzen van Zanten JJ, Willemsen G, Carroll D. Reliability of hematocrit during rest and stress in healthy adults. Biol Psychol. 2008;77:63–8.CrossRefPubMed
31.
Allen MT, Patterson SM. Hemoconcentration and stress: a review of physiological mechanisms and relevance for cardiovascular disease risk. Biol Psychol. 1995;41:1–27.CrossRefPubMed
32.
Haffman BB. Catecholamines, sympathomimetic drugs, and adrenergic receptor antagonists. In: Hardman JG, LE Limbird, Gilman AG, editors. Goodman and Gilman’s the pharmacological basis of therapeutics, vol. 250. 10th ed. New York: McGraw Hill; 2001.
33.
Varma DR, Shen H, Deng XF, Peri KG, Chemtob S, Mulay S. Inverse agonist activities of beta-adrenoceptor antagonists in rat myocardium. Br J Pharmacol. 1999;127:895–902.CrossRefPubMedPubMedCentral
34.
Bendjelid K, Romand JA. Fluid responsiveness in mechanically ventilated patients: a review of indices used in intensive care. Intensive Care Med. 2003;29:352–60.CrossRefPubMed
35.
Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37:2642–7.CrossRefPubMed
Metadata
Title
Effects of cardiac output on the initial distribution volume of glucose in the absence of fluid gain or loss in pigs
Authors
Toshinori Kasai
Eiji Hashiba
Junichi Saito
Kazuyoshi Hirota
Publication date
01-02-2017
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 1/2017
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-016-2272-4

Other articles of this Issue 1/2017

Journal of Anesthesia 1/2017 Go to the issue

Original Article

Goal directed fluid therapy decreases postoperative morbidity but not mortality in major non-cardiac surgery: a meta-analysis and trial sequential analysis of randomized controlled trials

Original Article

A comparison of single-handed chin lift and two-handed jaw thrust for tracheal intubation using a lightwand

Original Article

Continuous intravenous analgesia with fentanyl or morphine after gynecological surgery: a cohort study

Original Article

The effect of dexmedetomidine pretreatment on the median effective bolus dose of propofol for facilitating laryngeal mask airway insertion

Original Article

Validity of rhinometry in measuring nasal patency for nasotracheal intubtion

Original Article

Cost comparison of intrathecal morphine to intravenous patient-controlled analgesia for the first 24 h post cesarean delivery: a retrospective cohort study