The condition of the fluid compartments by the method of bioimpedancemetry in victims with a blast injury

Abstract

BACKGROUND. According to the modern standards, in case of an acute blood loss, the pathogenetic provision of fluid therapy is based on the ROSE/D concept. According to this concept, after the initial emergency restoration of circulating blood volume, the fluid compartments should be optimized with further stabilization of the condition.
 OBJECTIVE. To study the fluid compartments in mine-explosive injuries victims.
 MATERIALS AND METHODS. 28 servicemen aged 20 to 51 years (average age 34.6±10.3 years) who were in the intensive care unit (ICU) with mine-explosive injuries of various localization (chest, abdomen, limbs) were examined. The victims were given fluid therapy in a restrictive mode. The condition of fluid compartments was determined by the method of bioimpedance measurement and calculation methods.
 RESULTS. On the first day of ICU stay, the total amount of water in the body exceeded the norm by 3 %. At the same time, the volume of intracellular water was significantly lower than normal by 22 %. On the second day, the total amount of water in the body normalized, but the indicator of intracellular water increased by 9.5 % of the reference.
 CONCLUSIONS. It is shown that despite the restoration of the circulating blood volume, there is an intracellular fluid deficit, which, even in the conditions of the restrictive fluid therapy, is replaced by a slight compensatory intracellular hyperhydration the next day when the intravascular volume of fluid is normalized.