Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011;66(11):1969-74.
doi: 10.1590/s1807-59322011001100019.

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

Danilo Teixeira Noritomi  1 , Adriano José Pereira, Diogo Diniz Gomes Bugano, Paulo Sergio Rehder, Eliézer Silva
Affiliations
Comparative Study

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

Danilo Teixeira Noritomi et al. Clinics (Sao Paulo). 2011.

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.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Standard base excess (SBE), lactate and chloride plasma concentrations in the three groups.
See this image and copyright information in PMC

References

    1. Kaplan LJ, Kellum JA. Initial pH, base deficit, lactate, anion gap, strong ion difference, and strong ion gap predict outcome from major vascular injury. Crit Care Med. 2004;32:1120–4. 10.1097/01.CCM.0000125517.28517.74 - DOI - PubMed
    1. Mikhail J. The trauma triad of death: hypothermia, acidosis, and coagulopathy. AACN Clin Issues. 1999;10:85–94. 10.1097/00044067-199902000-00008 - DOI - PubMed
    1. Moore FA, McKinley BA, Moore EE, Nathens AB, West M, Shapiro MB, et al. Inflammation and the Host Response to Injury, a large-scale collaborative project: patient-oriented research core—standard operating procedures for clinical care III. Guidelines for shock resuscitation. . J Trauma. 2006;61:82–9. - PubMed
    1. Morgan TJ. The meaning of acid-base abnormalities in the intensive care unit: part III — effects of fluid administration. Crit Care. 2005;9:204–11. 10.1186/cc2946 - DOI - PMC - PubMed
    1. Ho AM, Karmakar MK, Contardi LH, Ng SS, Hewson JR. Excessive use of normal saline in managing traumatized patients in shock: a preventable contributor to acidosis. J Trauma. 2001;51:173–7. 10.1097/00005373-200107000-00033 - DOI - PubMed

Publication types

MeSH terms