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

Abstract

OBJECTIVE:

Intravenous infusion of crystalloid solutions is a cornerstone of the treatment of hemorrhagic shock. However, crystalloid solutions can have variable metabolic acid-base effects, perpetuating or even aggravating shock-induced metabolic acidosis. The aim of this study was to compare, in a controlled volume-driven porcine model of hemorrhagic shock, the effects of three different crystalloid solutions on the hemodynamics and acid-base balance.

METHODS:

Controlled hemorrhagic shock (40% of the total blood volume was removed) was induced in 18 animals, which were then treated with normal saline (0.9% NaCl), Lactated Ringer's Solution or Plasma-Lyte pH 7.4, in a blinded fashion (n = 6 for each group). Using a predefined protocol, the animals received three times the volume of blood removed.

RESULTS:

The three different crystalloid infusions were equally capable of reversing the hemorrhage-induced low cardiac output and anuria. The Lactated Ringer's Solution and Plasma-Lyte pH 7.4 infusions resulted in an increased standard base excess and a decreased serum chloride level, whereas treatment with normal saline resulted in a decreased standard base excess and an increased serum chloride level. The Plasma-Lyte pH 7.4 infusions did not change the level of the unmeasured anions.

CONCLUSION:

Although the three tested crystalloid solutions were equally able to attenuate the hemodynamic and tissue perfusion disturbances, only the normal saline induced hyperchloremia and metabolic acidosis.

• Authors: Danilo Teixeira Noritomi, Adriano José Pereira, Diogo Diniz Gomes Bugano, Paulo Sergio Rehder, Eliézer Silva
• Journal: Clinics (Sao Paulo, Brazil) (Clinics (Sao Paulo)) Vol. 66 Issue 11 Pg. 1969-74 ( 2011) ISSN: 1980-5322 [Electronic] United States
• PMID: 22086530 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Crystalloid Solutions
• Gluconates
• Isotonic Solutions
• Plasma-lyte 148
• Ringer's Lactate
• Magnesium Chloride
• Sodium Chloride
• Sodium Acetate
• Potassium Chloride

Topics

• Acid-Base Equilibrium (drug effects)
• Animals
• Crystalloid Solutions
• Disease Models, Animal
• Epidemiologic Methods
• Gluconates (adverse effects)
• Hemodynamics (drug effects)
• Hydrogen-Ion Concentration
• Isotonic Solutions (adverse effects, classification)
• Magnesium Chloride (adverse effects)
• Male
• Potassium Chloride (adverse effects)
• Ringer's Lactate
• Shock, Hemorrhagic (chemically induced, drug therapy)
• Sodium Acetate (adverse effects)
• Sodium Chloride (adverse effects)
• Swine