Ringer’S Lactate Versus Sterofundin ® Iso in Paediatric Surgical Patients: The Acid Base and Electrolytes Assessment

A method of intravenous anesthesia with sodium oxybutyrate in combination with drugs for neuroleptanalgesia and ataralgesia has been developed. The results of the use of anesthesia in 174 urgent surgical patients were analyzed. The normalization of acid-base balance under the influence of sodium oxybutyrate was noted.

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Acid-Base Balance in Surgical Patients

Southern Medical Journal ◽

10.1097/00007611-196305000-00022 ◽

1963 ◽

Vol 56 (5) ◽

pp. 551-556

Author(s):

RONALD WOOLMER

Keyword(s):

Surgical Patients ◽

Acid Base Balance ◽

Acid Base ◽

Base Balance

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Acid-Base Disorders in Surgical Patients

Acid-Base Disorders ◽

10.1007/978-3-030-28895-2_20 ◽

2019 ◽

pp. 305-308

Author(s):

Alluru S. Reddi

Keyword(s):

Surgical Patients ◽

Acid Base

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P0601SAFETY AND EFFICACY OF INTRAVENOUS ADMINISTRATION OF RINGER'S LACTATE VERSUS NORMAL SALINE 0.9% SOLUTION IN PATIENTS WITH ACUTE KIDNEY INJURY AND ESTABLISHED CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0601 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Marios Papasotiriou ◽

Adamantia Mpratsiakou ◽

Georgia Georgopoulou ◽

Lamprini Balta ◽

Paraskevi Pavlakou ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Renal Function ◽

Kidney Injury ◽

Acid Base Balance ◽

Acid Base ◽

Safety And Efficacy ◽

Ringer’S Lactate ◽

Base Balance ◽

The Mean

Abstract Background and Aims Crystalline solutions, such as normal saline 0.9% (N/S 0.9%) and Ringer's Lactate (L/R), are readily administered for increasing plasma volume. Despite the utility of administering N/S 0.9% to hypovolemic patients, the dose of 154 mmol of sodium (Na) contained in 1 L exceeds the recommended daily dose increasing the risk of sodium overload and hyperchloremic metabolic acidosis. In contrast, L/R solution has the advantage of lower Na content, significantly less chlorine and contains lactates which may be advantageous in patients with significant acidemia such as patients with acute kidney injury (AKI) and chronic kidney disease (CKD). The aim of the present study is to investigate the safety and efficacy of administration of L/R versus N/S 0.9% in patients with prerenal AKI and established CKD. Method The study included adult patients with known CKD stage II to V without need for dialysis, with prerenal AKI (AKIN Stage I to III Criteria). Patients with other forms of AKI as well as hypervolemia, heart congestion or hyperkalemia (serum K>5.5 meq/l) were excluded from the study. Patients were randomized in 1:1 ratio to receive intravenously either N/S 0.9% or L/R solution at a dose of 20 ml/kg body weight/day. We studied kidney function (eGFR: CKD-EPI) and response to treatment at discharge and at 30 days after discharge, duration of hospitalization, improvement in serum bicarbonate levels (HCO3), acid-base balance, serum potassium levels and the need for dialysis. Results The study included 26 patients (17 males) with a mean age of 59.1 ± 16.1 years. Thirteen patients received treatment with N/S 0.9% and the rest with L/R solution. Baseline demographic and clinical characteristics at hospital admission and historical data did not show any significant differences in both groups of patients. Renal function at the onset of AKI did not show significant differences between the two groups (16.4 ± 5.8 vs 16.9 ± 5.7 ml/min/1.73 m2, p=ns, treatment with N/S and L/R respectively). The mean volume of solutions received by the two groups (N/S 0.9% 1119 ± 374 vs L/R 1338 ± 364 ml/day, p=ns) as well as the mean total volume of liquids received per day, did not differ significantly (2888 ± 821 vs 3069 ± 728 ml/d, p=ns). Patients treated with L/R were discharged 1 day earlier than patients treated with N/S (5.2 ± 3.2 vs 6.2 ± 4.9 days of hospitalization, p=ns). Renal function improvement during hospitalization and 30 days after discharge did not differ significantly between the two groups. Patients that received L/R showed a higher increase in plasma HCO3 (ΔHCO3) concentration at discharge than those that received N/S 0.9% (4.9 ± 4.1 vs 2.46 ± 3.7 meq/l, p=ns) and pH increase (ΔpH) was slightly higher in those that received L/R solution (0.052 ± 0.066 vs 0.023 ± 0.071, p=ns). Patients treated with N/S 0.9% showed a greater decrease in serum potassium (ΔK) at discharge compared to those treated with L/R (-0.39 ± 1.03 vs -0.17 ± 0.43 meq/l, p=ns, respectively). No patient received acute dialysis treatment. Conclusion Administration of L/R solution as a hydration treatment to patients with prerenal AKI and established CKD is not inferior concerning safety and efficacy to N/S 0.9% solution. In addition, L/R administration seems to marginally improve acid-base balance in this specific group of patients.

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The Effects of Balanced Versus Saline-Based Hetastarch and Crystalloid Solutions on Acid-Base and Electrolyte Status and Gastric Mucosal Perfusion in Elderly Surgical Patients

Anesthesia & Analgesia ◽

10.1097/00000539-200110000-00003 ◽

2001 ◽

Vol 93 (4) ◽

pp. 811-816 ◽

Cited By ~ 307

Author(s):

Nicholas J. Wilkes ◽

Rex Woolf ◽

Marjorie Mutch ◽

Susan V. Mallett ◽

Tim Peachey ◽

...

Keyword(s):

Surgical Patients ◽

Acid Base ◽

Mucosal Perfusion ◽

Crystalloid Solutions ◽

Gastric Mucosal Perfusion

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Very early increase in nitric oxide formation and oxidative cell damage associated with the reduction of tissue oxygenation is a trait of blast casualties

Vojnosanitetski pregled ◽

10.2298/vsp0504273z ◽

2005 ◽

Vol 62 (4) ◽

pp. 273-280 ◽

Cited By ~ 12

Author(s):

Gordana Zunic ◽

Predrag Romic ◽

Marina Vuceljic ◽

Olivera Jovanikic

Keyword(s):

Nitric Oxide ◽

Cell Damage ◽

Venous Blood ◽

Blast Injury ◽

Surgical Patients ◽

Blast Injuries ◽

Acid Base ◽

Acid Base Status ◽

Group B ◽

Control Limits

Background. In our previous experimental studies, we found evidence for the increase of nitric oxide (NO) formation immediately after blast injury. In the present study we investigated whether NO overproduction was a trait for the period immediately after blast injury in humans. Concomitant metabolic disturbances were also studied, and compared to the alterations in other traumatized patients. Methods. Blast casualties (group B, n = 13), surgical patients with the hip replacement or fractures, not exposed to blast effects (group S, n = 7) and healthy volunteers as controls (group C, n = 10), were examined. Both arterial and venous blood samples were taken within 6 hours, and 24 hours after blast injuries or surgical procedures, respectively. Plasma levels of nitrite/nitrate (NOx), superoxyde anion (O2.-), sulfhydrils (SH), malondialdehyde (MDA) as well as acid-base status and other biochemical parameters (glucose, urea, creatinine, total proteins, albumin) were measured. Results. Significant, but transient increase in plasma NOx levels occurred only in group B. It was associated with the significant increase of hemoglobin oxygen (sO2) saturation of the venous blood and the concomitant decrease of its arterial - venous difference. In group S the venous sO2 decreased, its arterial - venous difference increased, while NOx levels were within the control limits. In both groups, other parameters of arterial acid-base status were kept within the control limits throughout the examined period. The decrease of SH levels were similar in the examined groups, while the increase of O2 .- was greater in group B. Conclusion. Early NO overproduction was a trait of blast injuries in humans, contributing to the reduction of tissue the oxygenation and intensifying the oxidative cell damage that had to be considered in the therapy of casualties with blast injuries. These alterations were different from those observed in other surgical patients without blast injuries.

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