New Concepts in Fluid Therapy for Patients with Intraabdominal Infection

  • E. Zadrobilek
Conference paper


Patients with severe intraabdominal infection develop volume requirements far beyond what would compensate for the estimated losses. These result from a massive shift of fluid and solutes from the intravascular to the interstitial compartment due to local and generalized permeability defects [2] and from fluid and solute losses via drainages or open packed laparostomy wounds. In addition to fluid losses from the circulation, the circulating blood volume usually is further decreased by the distributive defect associated with peripheral pooling of blood. The immediate consequences of delays in appropriate fluid therapy are inadequate organ perfusion and function.


Fluid Therapy Acute Necrotizing Pancreatitis Colloid Osmotic Pressure Intraabdominal Infection Pulmonary Artery Wedge Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Allen SJ, Drake RE, Williams JP, Laine GA, Gabel JC (1987) Recent advances in pulmonary edema. Crit Care Med 15:963–970PubMedCrossRefGoogle Scholar
  2. 2.
    Avila AA, Warshawski F, Sibbald W, Finley R, Wells G, Holliday R (1985) Peripheral lymph flow in sheep with bacterial peritonitis: evidence for increased peripheral microvascular permeability accompanying systemic sepsis. Surgery 97:685–695PubMedGoogle Scholar
  3. 3.
    Fleck A, Raines G, Hawker F, Trotters J, Wallace PI, Ledingham IMcA, Calman KC (1985) Increased vascular permeability: a major cause of hypalbuminaemia in disease and injury. Lancet 1:781–784PubMedCrossRefGoogle Scholar
  4. 4.
    Grundmann R, Heistermann S (1985) Postoperative albumin infusion therapy based on colloid osmotic pressure. A prospectively randomized trial. Arch Surg 120:911–915PubMedCrossRefGoogle Scholar
  5. 5.
    Hauser CJ, Shoemaker WC, Turpin I, Goldberg SJ (1980) Oxygen transport responses to colloids and crystalloids in critically ill surgical patients. Surg Gynecol Obstet 150:811–816PubMedGoogle Scholar
  6. 6.
    Puri VK, Weil MH, Michaels S, Carlson RW (1980) Pulmonary edema associated with reduction in plasma oncotic pressure. Surg Gynecol Obstet 151:344–348PubMedGoogle Scholar
  7. 7.
    Rackow EC, Falk JL, Siegel JS, Packman MI, Haupt MT, Kaufman BS, Putnam D (1983) Fluid resuscitation in circulatory shock: a comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med 11:839–850PubMedCrossRefGoogle Scholar
  8. 8.
    Rackow EC, Fein IA, Siegel J (1982) The relationship of the colloid osmotic-pulmonary artery wedge pressure gradient to pulmonary edema and mortality in critically ill patients. Chest 82:433–437PubMedCrossRefGoogle Scholar
  9. 9.
    Shoemaker WC (1987) Circulatory mechanisms of shock and their mediators. Crit Care Med 15:787–794PubMedCrossRefGoogle Scholar
  10. 10.
    Shoemaker WC, Hauser CJ (1979) Critique of crystalloid versus colloid therapy in shock and shock lung. Crit Care Med 7:117–124PubMedCrossRefGoogle Scholar
  11. 11.
    Sturm JA, Wisner DH (1985) Fluid resuscitation of hypovolemia. Intensive Care Med 11:227–230PubMedCrossRefGoogle Scholar
  12. 12.
    Sturm JA, Carpenter MA, Lewis FR, Graziano C, Trunkey DD (1979) Water and protein movement in sheep lung after septic shock: effect of colloid versus crystalloid resuscitation. J Surg Res 26:233–248CrossRefGoogle Scholar
  13. 13.
    Weil MH, Henning RJ, Morissette M, Michaels S (1978) Relationship between colloid osmotic pressure and pulmonary artery wedge pressure in patients with acute cardiorespiratory failure. Am J Med 64:643–650PubMedCrossRefGoogle Scholar
  14. 14.
    Wolf YG, Cotev S, Perel A, Manny J (1987) Dependence of oxygen consumption on cardiac output in sepsis. Crit Care Med 15:198–203PubMedCrossRefGoogle Scholar
  15. 15.
    Zadrobilek E, Schindler I, Redl G, Mauritz W, Gilly H, Sporn P, Steinbereithner K (1987) Intravascular Starling forces and extravascular lung water in advanced septic shock states. Prog Clin Biol Res 236B: 139–144PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • E. Zadrobilek

There are no affiliations available

Personalised recommendations