Barendrecht, B.W. (2016) De relatie tussen de toename van het perifeer weefsel oedeem door vloeistoftherapie en de afname van de microcirculatoire vaatoppervlakte in intensive care patiënten. thesis, Medicine.
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Abstract
Introduction: Fluid resuscitation is considered to be the cornerstone of shock treatment. Question is to which extend is the fluid therapy contributing to oxygen transport and from what point is the fluid responsible for edema formation and thereby counteracting with the therapy? Materials and methods: This is a single-center prospective observational study among three categories of patients: cardiac surgery, sepsis patients and healthy volunteers. Of all the subjects recordings were made with the in-vivo-microscope Cytocam-IDF® to assess the microcirculation. There were BIVA- measurements performed and all the vital signs and fluid balance were recorded. Results: 106 subjects were enrolled, 52 cardiothoracic patients, 29 sepsis patients and 25 healthy volunteers. Of both the cardiothoracic patients and sepsis patients, the total vessel density (TVD) was significantly lower than that of the healthy volunteers (p = 0.009). In the cardiothoracic patient group there is a weak correlation between fluid balance and TVD (rs = 0.31 and p = 0.023). This correlation is not found in the other patient group. The BIVA measurements showed a weak correlation between the combined results of the BIVA measurement and fluid balance. No correlation was found between the BIVA-measurement and reduction of the TVD. Conclusion: A weak or no correlation between fluid balance and the decrease of TVD was found. No further increase of the TVD with higher fluid balances could indicate an optimal fluid balance by particular illnesses. The TVD could thus function as a start and stop sign for fluid resuscitation with an optimum of 21mm2/mm2. This is ground for further research.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Boerma, Dr. E.C. and Internist-intensivist and Medisch Centrum Leeuwarden and Afdeling Intensive care |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:00 |
| Last Modified: | 25 Jun 2020 11:00 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2041 |
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