Abstract | INTRODUCTION: METHODS: We prospectively audited acid-base during the first 48 h of CRRT in 62 patients, using bicarbonate and lactate fluids. RESULTS: Baseline lactate was greater in the bicarbonate group (4.76 ± 0.77 vs. 2.92 ± 0.5 mmol/l, p < 0.01), but pH, bicarbonate, chloride and base excess were similar. Lactate fell significantly in the bicarbonate group to 2.88 ± 0.3 mmol/l at 24 h and 2.39 ± 0.2 mmol/l at 48 h, but not in the lactate group. Base excess improved more with bicarbonate, median increase in the first 24 h was 51.6% (29.1-96.9) versus 18.5% (-5 to 55) with lactate and 74.2% (38.5-123) versus 36.1% (-3.6 to 68), p < 0.05 at 48 h. However, there were no significant differences in bicarbonate, chloride, pH, blood pressure and vasopressor requirements. 13.3% of patients were switched from lactate to bicarbonate fluids due to failure to correct acidosis. Subgroup analysis of 19 patients with liver failure showed similar results. CONCLUSION:
Bicarbonate fluids led to a more rapid fall in lactate and greater improvement in base excess during CRRT, but not overall control of acidosis.
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Authors | B Agarwal, F Kovari, R Saha, S Shaw, A Davenport |
Journal | Nephron. Clinical practice
(Nephron Clin Pract)
Vol. 118
Issue 4
Pg. c392-8
( 2011)
ISSN: 1660-2110 [Electronic] Switzerland |
PMID | 21346374
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2011 S. Karger AG, Basel. |
Chemical References |
- Bicarbonates
- Dialysis Solutions
- Lactic Acid
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Topics |
- Acid-Base Equilibrium
(drug effects, physiology)
- Acidosis
(blood, therapy)
- Adult
- Aged
- Aged, 80 and over
- Bicarbonates
(administration & dosage, blood, chemistry)
- Dialysis Solutions
(administration & dosage, chemistry, metabolism)
- Female
- Humans
- Lactic Acid
(administration & dosage, blood, chemistry)
- Male
- Middle Aged
- Prospective Studies
- Renal Replacement Therapy
(methods)
- Water-Electrolyte Balance
(drug effects, physiology)
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