Fluid distribution during surgery in the flat recumbent, Trendelenburg, and the reverse Trendelenburg body positions
Authors' conclusion
General anesthesia caused retention of infused fluid with preferential distribution to the extravascular space. Both Trendelenburg positions had a modifying influence on the kinetic adaptations that agreed with the gravitational forces inflicted by tilting to body.
Study context
- Population
- Patients undergoing surgery under GA receiving 1–2 L of Ringer's solution over 30–60 min, and matched awake volunteers61 patients · 106 volunteers
- Exposure
- GA in flat recumbent, Trendelenburg (legs up) and reverse Trendelenburg (head up) positions vs awake volunteers
- Volunteersn = 106reference
- Outcome
- Fluid distribution and elimination (volume kinetic parameters)
Methodological detailspopulation volume kinetic analysis, matched awake volunteers
- Population volume kinetic analysis
- Matched awake volunteers
Main finding
As reported in the abstract
- GA decreased rate constant for urine output, flat recumbent
- 79%
- GA decreased rate constant for urine output, legs up
- 91%
- GA decreased rate constant for urine output, head up
- 91%
- GA decreased rate constant for return of distributed fluid to plasma, flat recumbent
- 32%
- GA decreased rate constant for return of distributed fluid to plasma, legs up
- 15%
- GA decreased rate constant for return of distributed fluid to plasma, head up
- 70%
Observational data: associations, not effects.
Original publication
Fluid distribution during surgery in the flat recumbent, Trendelenburg, and the reverse Trendelenburg body positions. Acta Anaesthesiol Scand. Published 30 May 2024. doi:10.
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