Influence of acetate containing fluid versus lactate containing fluid on acid-base status, electrolyte level, and blood lactate level in dehydrated dogs

Abstract

Background and Aim: Acetate or lactate buffered, balanced isotonic rehydration fluids are commonly used for fluid therapy in dogs and may influence acid-base and electrolyte status. This study aimed to assess acid-base status, electrolyte levels, and lactate levels in dehydrated dogs after receiving acetate or lactate-containing intravenous rehydration fluids. Materials and Methods: In this prospective, randomized study, 90 dehydrated dogs were included and randomized to receive acetate [Sterofundin® ISO B. Braun Vet Care (STERO), Germany) or lactate (Ringer-Lactat-Lösung nach Hartmann B. Braun Vet Care (RL), Germany] containing intravenous fluids for rehydration. The exclusion criteria were as follows: Age <6 months, liver failure, congestive heart failure, and extreme electrolyte deviation. Physical examination, venous blood gas, and lactate levels were analyzed before and after rehydration. The two groups were compared using t-test and Chi-square test. The significance level was set at p≤0.05. Results: Post-rehydration heart rate decreased in the STERO group (p<0.001) but not in the RL group (p=0.090). Lactate levels decreased in both groups STERO (p<0.001) and in group RL (p=0.014). Sodium and chloride levels increased during rehydration in group STERO (p<0.001; p<0.001) and group RL (p=0.002; p<0.001). There was a larger decrease in lactate levels in group STERO compared to group RL (p=0.047). Conclusion: Both solutions led to a mild increase in sodium and chloride levels and decreased lactate levels. The acetate-containing solution had an inferior effect on the decrease in lactate level.

Influence of acetate- vs. lactate-containing fluid bolus therapy on acid-base status, electrolytes, and plasma lactate in dogs

“…Overall, both fluid types seem to have a similarly low impact on the patients' acid-base status, when given as an intravenous bolus of 30 mL/kg. This is in accordance with another study in dehydrated dogs, which also found no significant difference in acid-base parameters between the two fluids, when administered over a period of 6 to 24 h for rehydration (41). According to a meta-analysis of 29 studies comparing acetate-and lactate-containing fluids, the results concerning the acid-base status were conflicting.…”

“…In another study, dehydrated dogs were resuscitated with either a lactate-containing, or an acetate-containing solution. The total fluid volume administered depended on the individual patients' requirements, but the median volume was > 100 mL/kg, administered over 6 to 24 h. Plasma lactate levels decreased significantly in both groups, but the decrease was more pronounced in the acetate-group (41). A study in people undergoing major surgeries found higher intraoperative lactate levels in patients receiving 10 mL/kg/h of a lactate-containing solution, compared with the same rate of an acetate-containing solution.…”

“…Only one study found an advantage of using lactate-free solutions regarding improvement of metabolic acidosis (24). Three other studies were conducted in hemodynamically stable patients (dehydrated dogs, healthy pigs under anesthesia, and piglets with experimentally impaired liver function) (26,41,42). Patients receiving lactate-containing solutions showed higher plasma lactate, or reduced plasma lactate clearance, compared with patients receiving lactate-free solutions in all three studies.…”