Preoperative assessment of body fluid disturbances in patients with obstructive jaundice

Postoperative renal dysfunction in obstructive jaundice (OJ) patients has b een associated with hypovolemia and depletion of the extracellular water co mpartment (ECW). The aim of the study was to evaluate the preoperative stat us of body compartments in OJ patients measured by two methods. In a prospe ctive study 39 OJ patients (11 benign and 28 malignant obstructions) were i nvestigated, with 15 healthy subjects used as a control group (CG). Bioelec trical impedance analysis (BIA) determinations and values derived from anth ropometric measurements were used to assess body compartment status. The co efficient of variation of BIA was below 4% in both OJ and CG subjects. No d ifferences were found in intracellular water. However total body water (TBW ) and ECW were reduced in OJ patients (50.5 +/- 4.6 vs. 56 +/- 8% body weig ht, p = 0.05; and 21 +/- 4.5 vs. 23.8 +/- 2.5% body weight,p < 0.05, respec tively). There were no differences between benign and malignant obstruction s. Seventy four percent of OJ patients had an ECW volume below the mean +/- 2 SD in the CG subjects. Anthropometric and BIA determinations correlated closely for TBW measurements in both CG (r = 0.92, p < 0.001) and OJ patien ts (r = 0.91, p < 0.001). Bland-Altman analysis also showed that for TBW th e BIA was in agreement with anthropometry. In the present study, BIA offere d a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.