Kinetic Method to Detect Dehydration

Study Overview
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Brief Summary
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The distribution and elimination of infusion fluids can be studied by volume kinetics, a mathematical method based on serial analysis of the blood hemoglobin concentration. The hypothesis of the present study is that the elimination of infused fluid is retarded in the presence of dehydration, and that volume kinetics would therefore be capable of detecting dehydration in human subjects. We induce dehydration by injection graded doses of furosemide (a diuretic drug) in healthy volunteers and the kinetics of an infusion of crystalloid fluid is compared to when the same volunteer receives the same fluid without being in a dehydrated state.

Detailed Description
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Fifteen healthy male volunteers are subjected to 4 experiments. They drink 800 ml of water at 6:00 AM to make sure they are not dehydrated when the experiments begin. On two occasions the volunteer receives, at 9:00 AM, an intravenous infusion of acetated Ringer´s solution being either 5 ml/kg or 10 ml/kg, over 15 min. The blood hemoglobin concentration is measured during 16 occasions during 120 min by invasive blood sampling and also non-invasively by a pulse oximeter (Masimo´s Radical 7). On two other occasions, the infusions are preceded for 2 hours of deliberate dehydration. Doses of furosemide 5 mg are repeated 3-4 times with the goal of creating dehydration amounting to approximately 2 liters of fluid. Excreted urine is collected and the volume measured. The kinetics of each infusion is calculated by volume kinetics, and the data compared pairwise from the experiments with and those without dehydration. The accuracy and precision of the non-invasive monitoring of Hgb can be determined. The study is ended with that the Hgb response between the lying and sitting position is compared and with that the fluid balance is restored by ingestion of water. Experiments are performed in the Department of Intensive Care at Linköping University Hospital, Sweden.

Official Title
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New Method to Detect Dehydration

Conditions
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Dehydration

Intervention / Treatment
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* Biological: Dehydration
* Biological: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy male. Exclusion Criteria: Disease for which daily medication is required. Poor peripheral perfusion; defined as a perfusion index, as measured by Masimo´s Radical 7, of 2 or less.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: 5 ml/kg of fluid, no dehydration<br>Volunteers receive an intravenous infusion of acetated Ringers solution over 15 min without preceding deliberate dehydration with furosemide. | Biological: Placebo<br>* No dehydration is induced<br>* Other names: Acetated Ringer´s solution;|
| Placebo Comparator: 10 ml/kg of fluid, no dehydration<br>Volunteers receive an intravenous infusion of acetated Ringers solution over 15 min without preceding deliberate dehydration with furosemide. | Biological: Placebo<br>* No dehydration is induced<br>* Other names: Acetated Ringer´s solution;|
| Experimental: 5 ml/kg of fluid, dehydration<br>Volunteers receive an intravenous infusion of 5 ml/kg acetated Ringers solution over 15 min after being dehydrated with furosemide. | Biological: Dehydration<br>* Furosemide 5 mg is given intravenously over 2 hours until approximately 2 liters of body fluid is lost.<br>* Other names: Acetated Ringer´s solution;|
| Experimental: 10 ml/kg of fluid, dehydration<br>Volunteers receive an intravenous infusion of 10 ml/kg acetated Ringers solution over 15 min after being dehydrated with furosemide. | Biological: Dehydration<br>* Furosemide 5 mg is given intravenously over 2 hours until approximately 2 liters of body fluid is lost.<br>* Other names: Acetated Ringer´s solution;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| As determined by volume kinetics, a healthy human male eliminates infused crystalloid fluid more slowly when being in the dehydrated state as compared to when being normohydrated. |  | December 2010 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The volume kinetics of an infusion fluid can/can not be measured as accurately by non-invasive monitoring as by invasive monitoring of the blood hemoglobin concentration |  | May 2010 (preliminary analysis) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dehydration, fluid therapy, pharmacokinetics, hemoglobin