Current issue
Journal content
Articles in press
Archive
About the Journal
About the Polish Annals of Medicine
Editorial Board
Abstracting & indexing
Open Access policy
Charges
Affiliated institutions
Contact
Instructions
Peer review process
Guide for authors
Publication ethics
Ethics and Patient Consent
User License
Usage of third party materials
Disclaimer
Statement on Artificial Intelligence
Reviewers
Guide for reviewers
Review Form
RESEARCH PAPER
Comparison of acid–base and electrolyte imbalances between normal saline and 1.4% sodium bicarbonate intravenous fluids therapy during cervical and lumbar laminectomy
1
Anesthesiology Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
2
Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
Submission date: 2016-02-22
Acceptance date: 2016-03-30
Online publication date: 2016-05-05
Publication date: 2019-12-19
Corresponding author
Hamidreza Karimi-Sari
Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran. Tel.: +98 2181264354; fax: +98 2181264354.
Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran. Tel.: +98 2181264354; fax: +98 2181264354.
Pol. Ann. Med. 2017;24(2):117-122
KEYWORDS
ABSTRACT
Introduction:
Large amounts of normal saline infused in surgeries can cause hyperchloremic metabolic acidosis.
Aim:
This study was designed to evaluate electrolyte and acid–base imbalances in the common fluid therapy method (normal saline) and the use of 1.4% sodium bicarbonate with normal saline fluid therapy during surgical laminectomy.
Material and methods:
In this double-blind randomized clinical trial patients from 35 to 70 years in age, having American Society of Anesthesiologists physical status class I–II, candidation for cervical and lumbar laminectomy in Baqiyatallah Hospital (Tehran, Iran) in 2015 were enrolled. Patients were randomized into either two groups receiving 1.4% sodium bicarbonate and normal saline intravenous solutions for deficit fluid therapy during the surgery. Hemodynamics, arterial blood gases, and electrolytes levels were measured before and after surgery. Data were compared between the groups by SPSS.
Results and discussion:
Forty patients with a mean age of 49.9 ± 12.7 years were evaluated. There were no significant differences in demographic data, mean surgery duration, blood loss, urine output, and infused fluid volumes between the two groups (P > 0.05). The mean PCO2 and HCO3 values significantly increased in the bicarbonate group, whereas they decreased significantly in the normal saline group. The mean serum lactate increased significantly in the bicarbonate group while the mean serum Cl– increased significantly in the normal saline group (P < 0.05).
Conclusions:
The results of this study showed the superiority of 1.4% sodium bicarbonate fluid in controlling acid–base and electrolyte imbalances during this kind of surgery, but it should be verified by further studies.
Large amounts of normal saline infused in surgeries can cause hyperchloremic metabolic acidosis.
Aim:
This study was designed to evaluate electrolyte and acid–base imbalances in the common fluid therapy method (normal saline) and the use of 1.4% sodium bicarbonate with normal saline fluid therapy during surgical laminectomy.
Material and methods:
In this double-blind randomized clinical trial patients from 35 to 70 years in age, having American Society of Anesthesiologists physical status class I–II, candidation for cervical and lumbar laminectomy in Baqiyatallah Hospital (Tehran, Iran) in 2015 were enrolled. Patients were randomized into either two groups receiving 1.4% sodium bicarbonate and normal saline intravenous solutions for deficit fluid therapy during the surgery. Hemodynamics, arterial blood gases, and electrolytes levels were measured before and after surgery. Data were compared between the groups by SPSS.
Results and discussion:
Forty patients with a mean age of 49.9 ± 12.7 years were evaluated. There were no significant differences in demographic data, mean surgery duration, blood loss, urine output, and infused fluid volumes between the two groups (P > 0.05). The mean PCO2 and HCO3 values significantly increased in the bicarbonate group, whereas they decreased significantly in the normal saline group. The mean serum lactate increased significantly in the bicarbonate group while the mean serum Cl– increased significantly in the normal saline group (P < 0.05).
Conclusions:
The results of this study showed the superiority of 1.4% sodium bicarbonate fluid in controlling acid–base and electrolyte imbalances during this kind of surgery, but it should be verified by further studies.
ACKNOWLEDGEMENTS
The authors would like to thank all physicians, nurses, and
staffs at the Operation Room of Baqiyatallah Hospital.
CONFLICT OF INTEREST
All of the authors mentioned no conflict of interests.
REFERENCES (21)
1.
Omron EM, Omron RM. A physicochemical model of crystalloid infusion on acid–base status. J Intensive Care Med. 2010;25(5):271–280.
2.
Carlesso E, Maiocchi G, Tallarini F, et al. The rule regulating pH changes during crystalloid infusion. Intensive Care Med. 2011;37(3):461–468.
3.
Nkilly GE, Michelet D, Hilly J, et al. Postoperative decrease in plasma sodium concentration after infusion of hypotonic intravenous solutions in neonatal surgery. Br J Anaesth. 2014;112(3):540–545.
4.
Scheingraber S, Rehm M, Sehmisch C, Finsterer U. Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery. Anesthesiology. 1999;90(5):1265–1270.
5.
Bagshaw SM, Townsend DR, McDermid RC. Disorders of sodium and water balance in hospitalized patients. Can J Anaesth. 2009;56(2):151–167.
6.
Woo SH, Desai S, Shieh L. Diagnosis and management of acid-base disorders. Hosp Med Clin. 2014;3(3):e334–e349.
7.
Shimada Y, Kitamura A, Nakanishi K, Hongo T, Kim C, Sakamoto A. Effect of bicarbonated Ringer's solution on the acid-base balance in patients undergoing abdominal aortic aneurysm repair. J Nippon Med Sch. 2005;72(6):364–369.
8.
Tie H-T, Luo M-Z, Luo M-J, Zhang M, Wu Q-C, Wan J-Y. Sodium bicarbonate in the prevention of cardiac surgeryassociated acute kidney injury: a systematic review and meta-analysis. Crit Care. 2014;18(5):517.
9.
Waters JH, Miller LR, Clack S, Kim JV. Cause of metabolic acidosis in prolonged surgery. Crit Care Med. 1999;27(10):2142–2146.
10.
Hofmann-Kiefer KF, Chappell D, Kammerer T, et al. Influence of an acetate-and a lactate-based balanced infusion solution on acid base physiology and hemodynamics: an observational pilot study. Eur J Med Res. 2012;17(1):1–8.
11.
Burdett E, Dushianthan A, Bennett-Guerrero E, et al. Buffered versus non-buffered fluids given to adults during surgery. Cochrane Database Syst Rev. 2012. http://dx.doi.org/10.1002/1465....
12.
Van Zyl DG, Rheeder P, Delport E. Fluid management in diabetic-acidosis – Ringer's lactate versus normal saline: a randomized controlled trial. QJM. 2012;105(4):337–343.
13.
Cortés DO, Bonor AR, Vincent J. Isotonic crystalloid solutions: a structured review of the literature. Br J Anaesth. 2014;112(6):968–981.
14.
Leverve XM, Boon C, Hakim T, Anwar M, Siregar E, Mustafa I. Half-molar sodium-lactate solution has a beneficial effect in patients after coronary artery bypass grafting. Intensive Care Med. 2008;34(10):1796–1803.
15.
Turner KR, Fisher E, Hade EM, Houle T, Rocco M. The role of perioperative sodium bicarbonate infusion affecting renal function after cardiothoracic surgery. Front Pharmacol. 2014;5:127.
16.
Schiffl H. Sodium bicarbonate infusion for prevention of acute kidney injury: no evidence for superior benefit, but risk for harm? Int Urol Nephrol. 2015;47(2):321–326.
17.
Nakayama M, Yamauchi M, Kanaya N, Namiki A. Utility of bicarbonated Ringer's solution as an intraoperative fluid during long-term laparotomy. Masui. 2007;56:1334–1338 [in Japanese].
18.
Tellan G, Antonucci A, Marandola M, et al. Postoperative metabolic acidosis: use of three different fluid therapy models. Chir Ital. 2007;60(1):33–40 [in Italian].
19.
Haase M, Haase-Fielitz A, Bellomo R, et al. Sodium bicarbonate to prevent increases in serum creatinine after cardiac surgery: a pilot double-blind, randomized controlled trial. Crit Care Med. 2009;37(1):39–47.
20.
McGuinness SP, Parke RL, Bellomo R, Van Haren FM, Bailey M. Sodium bicarbonate infusion to reduce cardiac surgeryassociated acute kidney injury: a phase II multicenter double-blind randomized controlled trial. Crit Care Med. 2013;41:1599–1607.
21.
Andou S, Morimoto Y. A comparison of acetated Ringer's solution and bicarbanated Ringer's solution for fluid therapy during extended hystectomy. Masui. 2010;59:971–975 [in Japanese].
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
