Studying Fluid Balance
The chloride content of 0.9% saline is 1.5 times that of plasma, and the infusion of large volumes of 0.9% saline can cause hyperchloremic acidosis, fluid overload, interstitial edema and adverse postoperative outcomes. In collaboration with the Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, and with funding from Baxter Healthcare, we compared the effects of infusions of 2-L 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers and also the effects of 1-L infusions of 6% hydroxyethyl starch suspended in 0.9% saline and a balanced solution (Plasma Volume Redibag) on blood volume, renal blood flow velocity, and renal cortical tissue perfusion in healthy volunteers. This work has helped to radically change the way that intravenous fluids are prescribed to patients who are undergoing major surgery. It has also helped to reduce postoperative complications by up to 41% and hospital stay for patients by 3 days, resulting in potential financial benefits of £122 million a year to the NHS. This was recognised at The University of Nottingham's inaugural Knowledge Exchange and Innovation Awards which showcased the impact of University research on business and society. Following this initial work, and with funding from BBraun, we compared the effects of colloid (4% gelatin) and crystalloid regimens on renal arterial blood flow and renal cortex perfusion as well as renal volume and renal cortex diffusion, cardiac index and aortic blood flow.
https://www.ncbi.nlm.nih.gov/pubmed/31668721