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Perioperative fluid therapy impairs lymphatic pump function in male rats
Rebecca C Harlow-Adamek1, Reetu Singh1, Randolph H Stewart1
1Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Department of Veterinary Physiology & Pharmacology, Texas A&M University, College Station, Texas, USA.
Physiological Reports
|June 11, 2025
Summary
Perioperative IV fluid therapy impairs lymphatic pump function, delaying recovery and worsening outcomes. This study shows reduced lymphatic pumping after surgery, highlighting a critical factor in post-operative edema and inflammation.
Area of Science:
- Physiology
- Surgical Recovery
- Lymphatic System Function
Background:
- Perioperative intravenous (IV) fluid therapy is essential but can cause sustained edemagenic stress.
- Persistent interstitial edema, or fluid accumulation, significantly hinders patient recovery and worsens outcomes.
- Understanding the impact of fluid therapy on lymphatic function is crucial for improving post-operative care.
Purpose of the Study:
- To investigate the hypothesis that perioperative IV fluid therapy compromises mesenteric lymphatic pump function within three days after major surgery.
- To elucidate the functional consequences of fluid therapy-induced interstitial edema on lymphatic vessels.
Main Methods:
- Animals underwent major abdominal surgery (midline laparotomy) followed by 48 hours of IV fluid therapy (FLTP) or sham surgery (CTRL).
- Mesenteric lymphatic vessels were isolated three days post-surgery for in vitro assessment of lymphatic pump function.
- Functional assessments included pressure-flow relationships, contraction frequency, and wall tension.
Main Results:
- Lymphatic vessels from FLTP animals exhibited significantly lower contraction frequency, normalized pump flow, and active/passive wall tensions compared to CTRL.
- The transmural pressure-pump flow relationship was altered in FLTP vessels.
- Surgically induced venous hypertension mimicked the pressure-flow alterations seen in FLTP, but not other functional deficits.
Conclusions:
- Perioperative IV fluid therapy detrimentally affects lymphatic pumping function.
- Compromised lymphatic pumping contributes to delayed resolution of interstitial edema and inflammation post-surgery.
- Restoring lymphatic function may be a therapeutic target for improving surgical recovery.
