• Robert G Hahn.
• Research Unit, Södertälje Hospital, Södertälje, Sweden. r.hahn@telia.com.
• Intensive Care Med Exp. 2020 Jul 10; 8 (1): 29.

BackgroundThe water volume of the endothelial glycocalyx layer has been estimated at 0.7 to 1.7 L using tracer methods of unclear value. The present study attempts to measure this fluid volume by analyzing the kinetics of a crystalloid fluid load.MethodsAn intravenous infusion of approximately 1 L of Ringer's acetate was administered to 35 healthy volunteers, and the central volume of distribution of the water volume was calculated from the urinary excretion and frequent measurements of the fluid-induced hemodilution using mixed-effects modeling software. Comparisons were made with the plasma volume derived from three published anthropometric regression equations based on isotope measurements. In a second analysis, up to 2.5 L of Ringer's was administered to 60 volunteers selected from a cohort of 160 to have as similar hematocrits as possible to the volunteers whose data were used to create the anthropometric equations.ResultsVolume kinetics showed that the infused crystalloid fluid occupied a larger central fluid space than was estimated with the isotope measurements. The first analysis of the 35 subjects indicated a mean difference of 0.51 L in males and 0.49 L in females. The second, larger analysis showed a mean excess volume of 0.43 L, which was approximately 15% of the circulating plasma volume.ConclusionsA crystalloid fluid load expands a 0.4-0.5 L larger central fluid space than the circulating plasma volume. The excess volume is probably located in the glycocalyx layer.

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