T. Tatara, T. Tsunetoh, C. Tashiro British Journal of Anaesthesia

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Crystalloid infusion rate during fluid resuscitation from acute haemorrhage T. Tatara, T. Tsunetoh, C. Tashiro British Journal of Anaesthesia Volume 99, Issue 2, Pages 212-217 (August 2007) DOI: 10.1093/bja/aem165 Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 1 Schematic diagram showing the compartmental model of the body and the relevant mass flows of fluid and protein. JHEM, haemorrhage rate; JINF, fluid infusion rate; JISL, insensible water losses; JIT, rate of fluid transfer from plasma to interstitium; JL, rate of fluid transfer from interstitium to lymphatics; JPER, perspiration rate; JU, rate of urine production; Q·HEM, rate of protein transfer by haemorrhage; Q·IT, rate of protein transfer from plasma to interstitium; QL, rate of protein transfer from interstitium to lymphatics. British Journal of Anaesthesia 2007 99, 212-217DOI: (10.1093/bja/aem165) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 2 Comparison of plasma dilution between experimental data of Drobin and Hahn5 and that predicted by our model during 25 ml kg−1 crystalloid infusion over 30 min in a 76 kg man when he was normovolaemic (a) and when 900 ml of blood was withdrawn over 15 min (b). The experimental data in normovolaemic state were used to obtain the estimated values of the fluid filtration coefficient and the permeability–surface area product for protein by a fitting procedure using our model (a). The time-course plasma dilution during crystalloid infusion after 900 ml of blood withdrawal was calculated by our model using these parameter values (b). British Journal of Anaesthesia 2007 99, 212-217DOI: (10.1093/bja/aem165) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 3 Time-course of crystalloid infusion rate (a) and volume changes in fluid compartments (b–d) during fluid resuscitation from a simulated haemorrhage of 15 ml kg−1 over 30 min in a 70 kg man at a bolus fluid infusion rate of 80 ml kg−1 h−1. British Journal of Anaesthesia 2007 99, 212-217DOI: (10.1093/bja/aem165) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 4 Time-course of crystalloid infusion rate (a) and total infusion volume (b) needed to restore and maintain blood volume at different bolus fluid infusion rates during fluid resuscitation from a simulated haemorrhage of 15 ml kg−1 over 30 min in a 70 kg man. Time 0 in (a) represents when fluid resuscitation was started. British Journal of Anaesthesia 2007 99, 212-217DOI: (10.1093/bja/aem165) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 5 Time-course of interstitial volume change (a), rate of fluid transfer from plasma to interstitium (JIT) (b), and hydrostatic pressure (c), and colloid osmotic pressure (d) differences between capillaries and interstitium during crystalloid resuscitation from a simulated haemorrhage of 15 ml kg−1 over 30 min in a 70 kg man. Time 0 represents when blood volume was restored to the pre-haemorrhage level. British Journal of Anaesthesia 2007 99, 212-217DOI: (10.1093/bja/aem165) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions