Abstract | OBJECTIVE: DESIGN: Randomized, prospective clinical study. SETTING: University hospital. PATIENTS: INTERVENTIONS: Patients were randomly assigned to receive either 250 mL of hypertonic saline dextran (HSD) or a conventional fluid regimen with 250 mL of hydroxyethyl starch in normal saline solution (H-NS) during the period of aortic clamping. Additionally, normal saline was used in both groups to reach a target pulmonary artery occlusion pressure of 15-18 mmHg. pH, Paco2, and serum concentrations of sodium, potassium, magnesium, calcium, chloride, lactate, albumin, and phosphate were measured. Strong ion difference was calculated as ( sodium + potassium + magnesium + calcium) - (chloride + lactate). The amount of weak plasma acid was calculated. MEASUREMENTS AND MAIN RESULTS: The infusion of HSD resulted in an immediate large increase in serum sodium (19 mmol/L) and chloride (22 mmol/L), whereas the infusion of H-NS led only to mild increases in serum sodium (3 mmol/L) and chloride (6 mmol/L). Both HSD and H-NS caused concomitant and equal decreases in the amount of weak plasma acid, strong ion difference, and pH (7.28-7.30). The reduction of bicarbonate was also identical and proportional to the extent of dilution due to infusion of HSD and H-NS. This induced metabolic acidosis was corrected spontaneously in both groups 24 hrs after surgery. CONCLUSION:
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Authors | Dirk Bruegger, Andreas Bauer, Markus Rehm, Markus Niklas, Matthias Jacob, Michael Irlbeck, Bernhard F Becker, Frank Christ |
Journal | Critical care medicine
(Crit Care Med)
Vol. 33
Issue 3
Pg. 556-63
(Mar 2005)
ISSN: 0090-3493 [Print] United States |
PMID | 15753747
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Dextrans
- Saline Solution, Hypertonic
- hypertonic saline-dextran solution
- Sodium Chloride
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Topics |
- Acid-Base Equilibrium
(drug effects)
- Acidosis
(etiology)
- Aged
- Analysis of Variance
- Aortic Aneurysm, Abdominal
(surgery)
- Dextrans
(adverse effects, pharmacology, therapeutic use)
- Female
- Fluid Therapy
(adverse effects, methods)
- Humans
- Male
- Perioperative Care
- Prospective Studies
- Saline Solution, Hypertonic
(adverse effects, pharmacology, therapeutic use)
- Sodium Chloride
(adverse effects, pharmacology, therapeutic use)
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