[Postoperative metabolic acidosis: use of three different fluid therapy models].

L'acidosi metabolica postoperatoria: impiego di tre differenti modeli di fluido-terapia.

Publisher: Società italiana di chirurgia Country of Publication: Italy NLM ID: 0151753 Publication Model: Print Cited Medium: Print ISSN: 0009-4773 (Print) Linking ISSN: 00094773 NLM ISO Abbreviation: Chir Ital Subsets: MEDLINE

Publication: 1998- : Roma : Società italiana di chirurgia
Original Publication: Milano [etc.] Istituto per la diffusione di opere scientifiche.

Acidosis/*therapy ; Fluid Therapy/*methods ; Isotonic Solutions/*therapeutic use ; Postoperative Complications/*therapy ; Sodium Chloride/*therapeutic use; Acid-Base Equilibrium ; Acidosis/blood ; Acidosis/etiology ; Acidosis, Lactic/blood ; Acidosis, Lactic/etiology ; Acidosis, Lactic/therapy ; Aged ; Algorithms ; Alkalosis/blood ; Alkalosis/chemically induced ; Chlorides/blood ; Colectomy ; Drug Combinations ; Female ; Fluid Therapy/adverse effects ; Humans ; Intraoperative Care ; Isotonic Solutions/administration & dosage ; Isotonic Solutions/adverse effects ; Male ; Middle Aged ; Models, Biological ; Postoperative Complications/blood ; Postoperative Complications/etiology ; Ringer's Lactate ; Sodium Chloride/administration & dosage ; Sodium Chloride/adverse effects

Intraoperative fluid administration is considered an important factor in the management of metabolic acidosis following surgical procedures. The aim of this study was to compare three types of intraoperative infusional models in order to evaluate their effect on acid-base changes in the immediate postoperative period as calculated by both the Henderson-Hasselbach equation and the Stewart approach. Forty-seven patients undergoing left hemicolectomy were enrolled in the study and assigned randomly to receiving 0.9% saline alone (Group A, n=16), lactated Ringer's solution alone (Group B, n=16) or 0.9% saline and Ringer's solution, 1:1 ratio (Group C, n=15). Arterial blood samples were taken before operation (t0) and 30 min after extubation (t1) in order to measure the acid-base balance. The results showed a metabolic acidosis status in Group A patients, whereas Group B exhibited metabolic alkalosis only by means of the Stewart method. No difference was found in Group C between the time points t0 and t1 when using either the Henderson-Hasselbach equation or using the Stewart model. We conclude that saline solution in association with Ringer's solution (1:1 ratio) appears to be the most suitable form of intraoperative fluid management in order to guarantee a stable acid-base balance in selected surgical patients during the immediate postoperative period.

0 (Chlorides)
0 (Drug Combinations)
0 (Isotonic Solutions)
0 (Ringer's Lactate)
451W47IQ8X (Sodium Chloride)

Date Created: 20080409 Date Completed: 20080523 Latest Revision: 20181201

20221213

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