The physiologic responses to a fluid bolus administration in old and young healthy adults

Organ function is known to decline with age. Optimizing cardiac, pulmonary and renal function in older adults has led to significant improvements in perioperative care. However, when substantial blood loss and fluid shifts occur, perioperative outcomes still remains poor, especially in older adults....

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Published in:Perioperative medicine (London) 2022-08, Vol.11 (1), p.30-30, Article 30
Main Authors: Cunningham, Cordell, Tapking, Christian, Salter, Michael, Seeton, Roger, Kramer, George C, Prough, Donald S, Sheffield-Moore, Melinda, Kinsky, Michael P
Format: Article
Language:English
Subjects:
Adults
Blood pressure
Cardiovascular
Catheters
Chronic illnesses
Diabetes
Disease
Elderly
Endothelium
Fluid response
Hemodynamics
Hemoglobin
Hormone replacement therapy
Older adults
Older people
Physiology
Plasma
Review boards
Strain gauges
Surgery
Ultrasonic imaging
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Summary:Organ function is known to decline with age. Optimizing cardiac, pulmonary and renal function in older adults has led to significant improvements in perioperative care. However, when substantial blood loss and fluid shifts occur, perioperative outcomes still remains poor, especially in older adults. We suspect that this could be due to age-related changes in endothelial function-an organ controlling the transport of fluid and solutes. The capillary filtration coefficient (CFC) is an important determinant of fluid transport. The CFC can be measured in vivo, which provides a tool to estimate endothelial barrier function. We have previously shown that the CFC increases when giving a fluid bolus resulting in increased vascular and extravascular volume expansion, in young adults. This study aimed to compare the physiologic determinants of fluid distribution in young versus older adults so that clinicians can best optimize perioperative fluid therapy. Ten healthy young volunteers (ages 21-35) and nine healthy older volunteers (ages 60-75) received a 10 mL/kg fluid bolus over the course of twenty minutes. Hemodynamics, systolic and diastolic heart function, fluid volumetrics and microcirculatory determinants were measured before, during, and after the fluid bolus. Diastolic function was reduced in older versus younger adults before and after fluid bolus (P 
ISSN:2047-0525
2047-0525
DOI:10.1186/s13741-022-00266-z