| Randomized Controlled Trial Comparing the Effect of 8.4% Sodium Bicarbonate and 5% Sodium Chloride on Raised Intracranial Pressure after Traumatic Brain Injury. | |
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MedLine Citation:
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PMID: 21298358 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Hypertonic sodium chloride solutions are routinely used to control raised intracranial pressure (ICP) after traumatic brain injury but have the potential to cause a hyperchloremic metabolic acidosis. Sodium bicarbonate 8.4% has previously been shown to reduce ICP and we have therefore conducted a randomized controlled trial to compare these two solutions. METHODS: Patients with severe traumatic brain injury were randomly allocated to receive an equiosmolar dose of either 100 ml of sodium chloride 5% or 85 ml of sodium bicarbonate 8.4% for each episode of intracranial hypertension. ICP and blood pressure were measured continuously. Arterial pCO(2), sodium, chloride, osmolality, and pH were measured at intervals. RESULTS: We studied 20 episodes of intracranial hypertension in 11 patients. Treatments with 8.4% sodium bicarbonate and 5% sodium chloride reduced raised ICP effectively with a significant fall in ICP from baseline at all time points (P < 0.001). There was no significant difference in ICP with time between those episodes treated with 5% sodium chloride or 8.4% sodium bicarbonate, P = 0.504. Arterial pH was raised after treatment with 8.4% sodium bicarbonate. CONCLUSIONS: An equiosmolar infusion of 8.4% sodium bicarbonate is as effective as 5% sodium chloride for reduction of raised ICP after traumatic brain injury when infused over 30 min. |
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Authors:
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Chris P Bourdeaux; Jules M Brown |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-5 |
Journal Detail:
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Title: Neurocritical care Volume: - ISSN: 1556-0961 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Intensive Care Unit, Frenchay Hospital, Frenchay Park Road, Bristol, BS16 1LE, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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