Fluids and body composition during anesthesia in children: a bioimpedance study

Abstract

Abstract PURPOSE: The assessment of total body fluid volume, intracellular volume and extracellular volume before and after anesthesia may be useful to define a better intraoperative fluid administration. METHODS: A bioimpedance spectroscopy device (BCM) was used to measure total body fluid volume, extracellular volume, intracellular volume. BCM-measurements were performed before and after general anesthesia in unselected healthy children and adolescents visiting the Pediatric Institute of Southern Switzerland for low-risk surgical procedures. RESULTS: In 100 children and adolescents aged 7.0 [4.8 – 11] years (median and interquartile range), the average total body water (TBW) increased perioperatively with a delta value of 182 [0 – 383] mL/m2 from pre- to postoperatively, as well as the extracellular water content (ECW), which had an equivalent increase with a delta value of 169 [19 – 307] mL/m2. The changes in TBW and ECW significantly correlated with the amount of fluids administered. CONCLUSIONS: This preliminary report shows that intraoperative fluid administration results in a significant fluid accumulation in low-risk schoolchildren during general anesthesia. Children without major health problems undergoing short procedures, do not need any perioperative intravenous fluid therapy, because they are allowed to take clear fluids up to 1 hour prior anesthesia. BCM-measurements could become useful for guiding intraoperative fluid therapy in future studies.