Perioperative noninvasive recognition of the TUR-syndrome in transurethral resections

Easily manipulable, noninvasive techniques for the immediate recognition of absorption of irrigating solution in transurethral prostate resections have not previously been available. For this reason, a way was sought to bring about an improvement in this situation: changes in the thoracic ground impedance were studied perioperatively by use of impedance cardiography during 16 transurethral resections. Furthermore, measurement of central venous pressure and arterial blood gases was done simultaneously as well as registration of myocardial function by systolic time intervals. Most important among the changes caused by absorption of irrigating solution which were registered with impedance cardiography are a significant increase in cardiac output and a considerable decrease in arterial oxygen pressure. Furthermore, a strong correlation was found between the increase of central venous pressure and the decrease of thoracic ground impedance. The relation of the preejection period to the left ventricular ejection time showed a significant increase due to impairment of myocardial function. The results show that impedance cardiography can monitor the time and extent of absorption of irrigating solution exactly and immediately and thus allows immediate therapy. This noninvasive technique can thus be used for perioperative supervision of the patient during transurethral prostate resections.