Measuring the size of the extracellular fluid space using bromide, iohexol, and sodium dilution

Anesth Analg. 2005 Dec;101(6):1770-1777. doi: 10.1213/01.ANE.0000184043.91673.7E.

Abstract

There is a need to find methods to assess the size of the extracellular fluid (ECF) volume without involving radioactive tracers. For this purpose, we applied 3 methods for measuring the ECF volume in 10 male volunteers (mean age, 34 yr). Steady-state plasma bromide concentration (control) was compared to the results of kinetic analysis of plasma iohexol and to kinetic analysis of the dilution of serum sodium after IV infusion of 1 L of isotonic mannitol. The volume of distribution of these tracers was used to indicate the ECF volume. The results disclosed statistically significant correlations between the results of all 3 methods, although the average sodium dilution showed 0.7 L lower values than iohexol and 1.4 L lower than bromide. All three methods correlated significantly with body weight. The percentage of the body weight indicated by the methods was 18.3% (3.1%) for sodium, 19.6% (1.0%) for iohexol, and 20.5% (1.1%) for bromide. We conclude that sodium dilution may be performed at bedside but iohexol and bromide showed less intersubject variability. Iohexol simultaneously measures the glomerular filtration rate and should be a viable clinical option if the hospital performs routine assessments of kidney function using this tracer.

MeSH terms

  • Adult
  • Bromides* / pharmacokinetics
  • Extracellular Fluid*
  • Glomerular Filtration Rate
  • Humans
  • Indicator Dilution Techniques*
  • Iohexol*
  • Male
  • Mannitol / pharmacokinetics
  • Middle Aged
  • Sodium*

Substances

  • Bromides
  • Mannitol
  • Iohexol
  • Sodium