Document Detail


A randomized clinical trial comparing the effect of rapidly infused crystalloids on acid-base status in dehydrated patients in the emergency department.
MedLine Citation:
PMID:  22211091     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To compare the effect of normal saline (NS), lactated Ringer's, and Plasmalyte on the acid-base status of dehydrated patients in the emergency department (ED).
METHOD: We conducted a prospective, double-blind, randomized trial of consecutive adult patients who presented to the emergency department with moderate-severe dehydration. Patients were randomly allocated to blindly receive normal saline (NS), lactated Ringer's or Plasmalyte at 20 ml/kg/h for 2 hours. Outcome measures of the study were pH and changes in electrolytes, including serum potassium, sodium, chloride and bicarbonate levels at 0, 60, and 120 minutes in venous blood gas samples.
RESULTS: Ninety patients participated in the study and were randomized to NS (30 patients), lactated Ringer's (30 patients) and Plasmalyte (30 patients) groups. Mean age was 48±20 years and 50% (n=45) of the patients were female. All pH values were in the physiological range (7.35-7.45) throughout the study period. In the NS group there was a significant tendency to lower pH values, with pH values of 7.40, 7.37, and 7.36 at 0, 1, and 2 hours respectively. Average bicarbonate levels fell in the NS group (23.1, 22.2, and 21.5 mM/L) and increased in the Plasmalyte group (23.4, 23.9, and 24.4 mM/L) at 0, 1, and 2 hours, respectively. There were no significant changes in potassium, sodium, or chloride levels.
CONCLUSIONS: NS, lactated Ringer's, and Plasmalyte have no significant effect on acid-base status and all can be used safely to treat dehydrated patients in the emergency department. However, NS can effect acidosis which might be significant in patients who have underlying metabolic disturbances; thus, its use should be weighed before fluid administration in the ED.
Authors:
Hakan Hasman; Orhan Cinar; Ahmet Uzun; Erdem Cevik; Loni Jay; Bilgin Comert
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2011-11-23
Journal Detail:
Title:  International journal of medical sciences     Volume:  9     ISSN:  1449-1907     ISO Abbreviation:  Int J Med Sci     Publication Date:  2012  
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-06-19     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101213954     Medline TA:  Int J Med Sci     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Gulhane Military Medical Academy, GATA Acil Tip Anabilim Dali, Etlik, Ankara, Turkey. hakan_has@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bicarbonates / blood
Chlorides / blood
Dehydration / blood,  drug therapy*
Double-Blind Method
Electrolytes / administration & dosage
Emergency Treatment*
Female
Humans
Hydrogen-Ion Concentration
Isotonic Solutions / administration & dosage*
Male
Middle Aged
Potassium / blood
Sodium / blood
Sodium Chloride / administration & dosage
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Chlorides; 0/Electrolytes; 0/Isotonic Solutions; 0/crystalloid solutions; 7440-09-7/Potassium; 7440-23-5/Sodium; 7647-14-5/Sodium Chloride; 8022-63-7/Ringer's lactate; 97397-05-2/Plasmalyte A
Comments/Corrections

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