Quick search Find article
Quick search
Find article

Accurate measurement of extracellular fluid volume from the slope/intercept technique after bolus injection of a filtration marker

Nicholas J Bird1, A Robert Michell2 and A Michael Peters1,3

Show affiliations


Extracellular fluid volume (ECV) is studied infrequently. The zero-time distribution volume (Vd) generated in the slope-intercept technique for measuring the glomerular filtration rate (GFR) substantially overestimates ECV. The aim was to validate a new technique for measuring ECV from the slope-intercept approach. GFR and ECV were measured using Cr-51-EDTA and iohexol injected into opposite arms in 51 patients undergoing routine measurement of GFR and on 48 occasions in 20 healthy volunteers. Blood samples were obtained bilaterally 20, 40, 60, 120, 180 and 240 min post-injection and assayed for indicator injected contralaterally. Reference ECV (ECV6) was calculated from all six samples as the product of indicator transit time and multi-sample GFR. GFR/ECV was calculated as the rate constant of the exponential fitted to the last three samples (GFR/ECV3). Slope-intercept GFR was calculated from the last three samples using the slope-intercept technique (GFR3). ECV (ECV3) was calculated by dividing GFR3 by GFR/ECV3, having corrected both for their one-compartment assumptions. ECV6EDTA correlated closely with ECV3EDTA (ECV3EDTA = 1.01.ECV6EDTA–0.5 L; r = 0.97; n = 99), but less closely with Vd (Vd = 1.17.ECV6EDTA + 0.7 L; r = 0.86). ECV6iohexol correlated slightly better with ECV6 EDTA (ECV6EDTA = 0.81.ECV6iohexol + 3.3 L; r = 0.86) than with ECV3EDTA (ECV3EDTA = 0.83.ECV6iohexol + 2.9 L; r = 0.84) and had slightly narrower 95% limits of agreement (−3.82 and 2.82 L versus −3.90 to 3.43 L). In conclusion, ECV can be measured from three samples almost as accurately as ECV from multiple samples.


PACS

87.80.-y Biophysical techniques (research methods)

47.63.-b Biological fluid dynamics

02.70.Rr General statistical methods

Subjects

Fluid dynamics

Computational physics

Instrumentation and measurement

Medical physics

Biological physics

Dates

Issue 12 (December 2009)

Received 22 July 2009, accepted for publication 25 September 2009

Published 28 October 2009



View by subject




Export








Please login to access our web services, or create an account if you don't yet have one.

You must have cookies enabled in your web browser to be able to login.

Username
Password

Forgotten your password? Get a new one here.