Impact of Plasma-Lyte pH 7.4 on acid-base status and hemodynamics in a model of controlled hemorrhagic shock

Noritomi, Danilo Teixeira; Pereira, Adriano José; Bugano, Diogo Diniz Gomes; Rehder, P.; Silva, Eliézer

doi:10.1590/s1807-59322011001100019

Cited by 31 publications

(21 citation statements)

References 31 publications

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“…Although other commercially available products provide slightly higher sodium content along with metabolizable bases, the difference is generally deemed clinically insignificant with no distinction between products such as LRS, Normosol R (Pfizer, New York, NY), or Plasma-Lyte (Baxter, Deerfield, IL). Although there is limited evidence comparing the efficacy of these balanced solutions, currently little clinical difference is seen between them (Noritomi et al, 2011). Severely acidotic calves benefit from isotonic or hypertonic sodium bicarbonate, but acetated or lactated Ringer's solution is preferred for mildly affected calves (Berchtold, 2009).…”

Section: Discussionmentioning

confidence: 99%

Comparison of a commercially available oral nutritional supplement and intravenous fluid therapy for dehydration in dairy calves

Taylor

Rodenburg²,

Snider

2017

Journal of Dairy Science

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Calf scours is a primary cause of morbidity and mortality in the dairy industry. Effective treatments are needed to minimize death, maximize welfare, and maintain growth and productivity. The objective of this trial was to compare the efficacy of a commercially available nutritional supplement (Diaque, Boehringer-Ingelheim Vetmedica Inc., St. Joseph, MO) and i.v. lactated Ringer's solution (LRS) in rehydrating, preventing acidemia, and correcting electrolyte imbalances in an experimental model for calf scours. Twenty-four colostrum-fed suckling dairy calves were used in a modified crossover design. An osmotic diarrhea was induced by orally feeding commercial milk replacer modified with high level of sucrose to create a hypertonic milk solution, and administering oral hydrochlorothiazide and spironolactone for 48 h. The intention was to create a challenge sufficient to result in moderately dehydrated, standing calves without producing severe depression or loss of suckle. The efficacy of i.v. fluid therapy and a commercial nutritional supplement were subsequently compared for reversing the effects of the diarrheal disease. Treatment A consisted of administering the nutritional supplement according to label directions (100 g in 1.9 L of warm water, 3 times a day), and treatment B consisted of i.v. LRS (2 L, once a day). Clinical signs and laboratory results were obtained once daily by a blinded observer. The induction method was effective in creating the desired effect, as demonstrated by weight loss and subjective health and hydration scores. Both treatment groups experienced increases in body weight, base excess, and bicarbonate, and decreases in total protein and packed cell volume following treatment. Both i.v. LRS and Diaque are effective methods to correct hypovolemia and control derangements in acid-base status in calves with diarrhea and dehydration.

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Section: Discussionmentioning

confidence: 99%

Comparison of a commercially available oral nutritional supplement and intravenous fluid therapy for dehydration in dairy calves

Taylor

Rodenburg²,

Snider

2017

Journal of Dairy Science

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“… 18 After removal of 40% of total blood volume in three equal aliquots at 30-min intervals, pigs received saline (mean volume infused: 2865 ml), RL (2774 ml), or Plasma-Lyte (2681 ml), in a blinded manner over 15 min, at a volume that was three times that of the blood removed. 19 All three solutions attenuated hemorrhage-induced low cardiac output and anuria equally, but saline induced negative base excess and a significant hyperchloremia. 19 …”

Section: Animal Studiesmentioning

confidence: 94%

“… 19 All three solutions attenuated hemorrhage-induced low cardiac output and anuria equally, but saline induced negative base excess and a significant hyperchloremia. 19 …”

Section: Animal Studiesmentioning

confidence: 94%

Should chloride-rich crystalloids remain the mainstay of fluid resuscitation to prevent ‘pre-renal’ acute kidney injury?: con

Lobo

Awad

2014

Kidney International

130

106

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The high chloride content of 0.9% saline leads to adverse pathophysiological effects in both animals and healthy human volunteers, changes not seen after balanced crystalloids. Small randomized trials confirm that the hyperchloremic acidosis induced by saline also occurs in patients, but no clinical outcome benefit was demonstrable when compared with balanced crystalloids, perhaps due to a type II error. A strong signal is emerging from recent large propensity-matched and cohort studies for the adverse effects that 0.9% saline has on the clinical outcome in surgical and critically ill patients when compared with balanced crystalloids. Major complications are the increased incidence of acute kidney injury and the need for renal replacement therapy, and that pathological hyperchloremia may increase postoperative mortality. However, there are no large-scale randomized trials comparing 0.9% saline with balanced crystalloids. Some balanced crystalloids are hypo-osmolar and may not be suitable for neurosurgical patients because of their propensity to cause brain edema. Saline may be the solution of choice used for the resuscitation of patients with alkalosis and hypochloremia. Nevertheless, there is evidence to suggest that balanced crystalloids cause less detriment to renal function than 0.9% saline, with perhaps better clinical outcome. Hence, we argue that chloride-rich crystalloids such as 0.9% saline should be replaced with balanced crystalloids as the mainstay of fluid resuscitation to prevent ‘pre-renal' acute kidney injury.

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“…in 2011, using normal saline in the treatment of hemorrhagic shock induced in animals caused reduction in BE and created hyper-chlormic acidosis. [20] In the present study, patients receiving 1.3% sodium bicarbonate in half-normal saline solution had more stability on changes in BE, SID, Cl and pH. Thus, it seems likely that in the presence of bicarbonate ion and also having fewer ions to normal saline, the serum does not lead to hyperchlormic acidosis and reducing SID.…”

Section: Discussionmentioning

confidence: 48%

Acid–base and hemodynamic status of patients with intraoperative hemorrhage using two solution types: Crystalloid Ringer lactate and 1.3% sodium bicarbonate in half-normal saline solution

et al. 2016

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Background:Intraoperative hemorrhage is one of the problems during surgery and, if it happens in a high volume without an immediate action to control, it can be fatal. Nowadays, various injectable solutions are used. The aim of this study was to compare the acid–base and hemodynamic status of the patient using two solutions, Ringer lactate and 1.3% sodium bicarbonate, in half saline solution.Materials and Methods:This clinical trial was performed at the Al-Zahra Hospital in 2013 on 66 patients who were randomly selected and put in two studied groups at the onset of hemorrhage. For the first group, crystalloid Ringer lactate solution and for the second group, 1.3% sodium bicarbonate in half-normal saline solution was used. Electrocardiogram, heart rate, O2 saturation non-invasive blood pressure and end-tidal CO2 were monitored. The arterial blood gas, blood electrolytes, glucose and blood urea nitrogen were measured before serum and blood injection. After the infusion of solutions and before blood transfusions, another sample was sent for measurement of blood parameters. Data were analyzed using SPSS software.Results:The mean arterial pressure was significantly higher in the second group than in the first group at some times after the infusion of solutions. pHh levels, base excess, bicarbonate, sodium, strong ion differences and osmolarity were significantly greater and potassium and chloride were significantly lower in the second group than in the first group after the infusion of solutions.Conclusion:1.3% sodium bicarbonate in half-normal saline solution can lead to a proper correction of hemodynamic instability. By maintaining hemodynamic status, osmolarity and electrolytes as well as better balance of acid–base, 1.3% sodium bicarbonate solution in half-normal saline solution can be more effective than Ringer lactate solution during intraoperative bleeding.

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Impact of Plasma-Lyte pH 7.4 on acid-base status and hemodynamics in a model of controlled hemorrhagic shock

Cited by 31 publications

References 31 publications

Comparison of a commercially available oral nutritional supplement and intravenous fluid therapy for dehydration in dairy calves

Comparison of a commercially available oral nutritional supplement and intravenous fluid therapy for dehydration in dairy calves

Should chloride-rich crystalloids remain the mainstay of fluid resuscitation to prevent ‘pre-renal’ acute kidney injury?: con

Acid–base and hemodynamic status of patients with intraoperative hemorrhage using two solution types: Crystalloid Ringer lactate and 1.3% sodium bicarbonate in half-normal saline solution

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