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Acid-based disturbances due to perioperative fluid therapy with slightly alkalized and acid-based neutral balanced crystalloids: a comparative study
1Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Czech Republic
2 Department of Surgery I, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Czech Republic
3 Department of Pharmacology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
4 Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
5 Transplantation Center, University Hospital Olomouc, Czech Republic
*Corresponding Author(s): MAREK SZKORUPA E-mail: Marek.Szkorupa@fnol.cz
The study aimed at comparing the effects of perioperatively administered balanced crystalloid infusion solutions, containing varied quantities of metabolizable anions, on homeostasis. In the prospective rand-omized open label study, patients were as-signed to Plasmalyte (PL) and Ringerfun-din (RF) Groups. The infusion solutions were parenterally administered at 1000 mL/6 hours. Arterialized capillary blood was sampled at the time of transfer to the Intensive Care Unit (ICU) (Time 0), and again at both 2 and 6 hours from Time 0. The collected blood was tested for blood gas parameters. A total of 112 patients were en-rolled in the study. There was no significant difference (P=0.329) in baseline pH values between the same-sized PL and RF Groups, with median pH values of 7.34 and 7.32, respectively. Similarly, no significant dif-ferences were seen in pH values measured after 2 hours (P=0.436), with median values of 7.38 for the PL Group and 7.37 for the RF Group. Finally, no significant differenc-es were observed after 6 hours (P=0.528), with median values of 7.41 and 7.40, re-spectively. Over time, pH values increased significantly in both groups (P≤0.001). There were no significant changes in either baseline base excess, actual bicarbonate, standard bicarbonate, partial pressure O2 and CO2 values, measured after 2 and 6 hours between the PL and RF Groups. The study failed to show differences between the balanced solutions Plasmalyte, in 5% glucose, and Ringerfundin, on the effects of pH and other acid-base parameters in pa-tients receiving postoperative care follow-ing elective surgery.
crystalloids, fluid therapy, Plas-malyte, Ringerfundin, acid base, internal environment
RADOVAN UVIZL,TOMAS BOHANES,KAREL URBANEK,MAREK SZKORUPA,LENKA DOU- BRAVSKA,JANA ZAPLETALOVA,MICHAEL DLOUHY,MONIKA HRABALOVA. Acid-based disturbances due to perioperative fluid therapy with slightly alkalized and acid-based neutral balanced crystalloids: a comparative study. Signa Vitae. 2017. 13(1);65-69.
1. Druey KM, Greipp PR. Narrative Review: The Systemic Capillary Leak Syndrome. Ann Intern Med 2010;153(2):90-8. doi:10.7326/0003-4819-153-2-201007200-00005
2. Doherty M, Buggyl DJ. Intraoperative fluids: how much is too much? BJA 2012;1:11.
3. Strunden MS, Heckel K, Goetz AE, Reuter DA. Perioperative fluid and volume management: physiological basis, tools and strategies. Ann Intensive Care 2011;1:2.
4. Nisanevich V, Felsenstein I, Almogy G, Weissman C, Einav S, Matot I. Effect of intraoperative fluid management on outcome after intraabdominal surgery. Anesthesiology 2005;103:25-32.
5. National Institute of Health and Care Excellence (NICE). Intravenous Fluid Therapy in Adults in Hospital. 2013. www.nice.org.uk/CG174
6. Powell-Tuck J, Gosling P, Lobo DN, Allison SP, Carlson GL, Gore M. British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients. BMJ 2009;338:2418.
7. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infu-sions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 2012;256(1):18-24.
8. Zadák Z, Hyšpler R, Hronek M, Tichá A. The energetic and metabolic effect of Ringerfundin (B.Braun) infusion and comparison with Plasma-Lyte (Baxter) in healthy volunteers. Acta Medica (Hradec Králové) 2010;53(3):131-7.
9. Kirkendol PL, Starrs J, Gonzalez FM. The effects of acetate, lactate, succinate and gluconate on plasma pH and electrolytes in dogs. Trans Am Soc Artif Intern Organs 1980;26:323-7.
10. Zavorsky GS, Cao J, Mayo NE, Gabbay R, Murias JM. Arterial versus capillary blood gases: A meta-analysis. Respir Physiol Neurobiol 2007;155:268-79.
11. Lowell JA, Schifferdecker C, Driscoll DF, Benotti PN, Bistrian BR. Postoperative fluid overload: not a benign problem. Crit Care Med 1990;18(7):728-33.
12. Holte K, Jensen P, Kehlet H. Physiologic effects of intravenous fluid administration in healthy volunteers. Anesth Analg 2003;96(5):1504-9.
13. Bouchard J, Mehta RL. Fluid balance issues in the critically ill patient. Contrib Nephrol 2010;164:69-78.
14. Simmons RS, Berdine GG, Seidenfeld JJ, Prihoda TJ, Harris GD, Smith JD. Fluid balance and the adult respiratory distress syndrome. Am Rev Respir Dis 1987;135(4):924-9.
15. Rahbari NN, Zimmermann JB, Schmidt T, Koch M, Weigand MA, Weitz J. Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery. Br J Surg 2009;96(4):331-41.
16. Kocian P, Neumann J, Majtan P, Hoch J. Fluid therapy and surgical outcomes after low anterior resection. Rozhl Chir 2014;93(9):463-7.
17. Brandstrup B. Fluid therapy for the surgical patient. Best Pract Res Clin Anaesthesiol 2006;20(2):265-83.
18. Holte K, Klarskov B, Christensen DS, Lund C, Nielsen KG, Bie P. Liberal versus restrictive fluid administration to improve recovery after laparoscopic cholecystectomy: a randomized, double-blind study. Ann Surg 2004;240(5):892-9.
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