The influence of fluid restriction on the patient’s water distribution during video-assisted thoracoscopy (VATS) – A preliminary report

• Authors: Piotr Wichary , Denis Kowalski , Martyna Czaja , Sławomir Mika , Jolanta Zalejska-Fiolka , Szymon Białka

Title variants

PL

Wpływ restrykcji płynowej na dystrybucję wody u pacjenta podczas wideotorakoskopii (VATS) – doniesienie wstępne

• Languages of publication: EN PL

Abstracts

EN

INTRODUCTION: The principles of optimal perioperative fluid therapy in thoracic surgery have been discussed for many years due to its possible role in pulmonary complications. The aim of the study was to perform a preoperative analysis of bioelectrical impedance (BIA) in patients undergoing video-assisted thoracoscopic surgery (VATS) using one-lung ventilation. MATERIAL AND METHODS: The study comprised 14 adult patients (11 men and 3 women). BIA was applied to measure total body water (TBW), intracellular body water (ICW), and extracellular body water (ECW) prior to the operation and after the patient’s return to the ward. The patients were grouped according to the total water received during the surgery per kilogram of body weight. The accepted cut-off value for restrictive fluid therapy was < 6.5 ml/kg of all fluids received during surgery. RESULTS: A small elevation of TBW was observed after the surgeries as compared to preoperational values. In restrictive fluid therapy, the values raised from 46.55% (95% CI: 41.58; 51.58) to 46.92% (95% CI: 42.92; 51.32), while for liberal volumes of fluids given during the procedures, the values grew from 37.26% (95% CI: 37.97; 41.56) to 37.63% (95% CI: 33.82; 41.43). However, the differences were not statistically significant (p = 0.983) and fluctuations in the intracellular and extracellular water were unremarkable in both groups. CONCLUSIONS: Restrictive fluid therapy does not affect intracellular and extracellular water distribution in patients undergoing VATS.

PL

WSTĘP: Zasady prowadzenia optymalnej płynoterapii okołooperacyjnej w trakcie zabiegów torakochirurgicznych są przedmiotem debaty od wielu lat z powodu możliwego związku z rozwojem powikłań płucnych. Celem badania była analiza wpływu płynoterapii restrykcyjnej z użyciem impedancji bioelektrycznej (bioelectrical impedance analysis – BIA) u pacjentów poddawanych operacjom wideotorakoskopowym (video-assisted thoracoscopic surgery – VATS) z wentylacją jednym płucem. MATERIAŁ I METODY: Badanie przeprowadzono u 14 dorosłych pacjentów (11 mężczyzn i 3 kobiety). Za pomocą BIA dokonywano pomiarów wody całkowitej (total body water – TBW), wewnątrzkomórkowej (intracellular body water – ICW) i zewnątrzkomórkowej (extracellular body water – ECW) przed operacją oraz po powrocie pacjenta na salę chorych. Pacjentów podzielono ze względu na całkowitą ilość płynów otrzymanych podczas operacji w przeliczeniu na kilogram masy ciała. Za wartość graniczną dla restrykcyjnej płynoterapii przyjęto < 6,5 ml/kg wszystkich płynów podanych podczas operacji. WYNIKI: Po zabiegach obserwowano niewielki wzrost ilości TBW w porównaniu z wartościami przedoperacyjnymi. Dla restrykcyjnej płynoterapii wartości wzrosły z 46,55% (95% CI = 41,58; 51,58) do 46,92% (95% CI = 42,92; 51,32), natomiast w przypadku dowolnej ilości podanych płynów z 37,26% (95% CI = 37,97;41,56) do 37,63% (95% CI = 33,82; 41,43). Jednak różnice te nie były istotne statystycznie (p = 0,983). Wahania w ilości wody wewnątrzkomórkowej i zewnątrzkomórkowej w obu grupach były nieznaczne. WNIOSKI: Płynoterapia restrykcyjna nie wpływa na dystrybucję wody wewnątrzkomórkowej i zewnątrzkomórkowej u pacjentów poddawanych VATS.

Keywords

EN

TBW; VATS; analiza impedancji bioelektrycznej; bioelectrical impedance analysis; całkowita zawartość wody w organizmie; dystrybucja wody; perioperative fluid therapy; płynoterapia okołooperacyjna; płynoterapia restrykcyjna; restrictive fluid therapy; total body water; video-assisted thoracoscopy; water distribution; wideotorakoskopia

Discipline

• MEDICINE: MEDICINE

• Publisher: Śląski Uniwersytet Medyczny w Katowicach
• Journal: Annales Academiae Medicae Silesiensis
• Year: 2025
• Volume: 79
• Pages: 276–281

Contributors

author

Piotr Wichary

• Department of Anaesthesiology and Critical Care, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

author

Denis Kowalski

• Department of Anaesthesiology and Critical Care, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

author

Martyna Czaja

• University Clinical Center named after Prof. K. Gibiński of the Medical University of Silesia in Katowice, Poland

author

Sławomir Mika

• Medica Co., Ltd. (Upper Silesian School of Ultrasonography), Chorzów, Poland

author

Jolanta Zalejska-Fiolka

• Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice,

author

Szymon Białka

• Department of Anaesthesiology and Critical Care, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland

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• Document Type: article