Comparative Randomized Study Of Balanced Salt Solution And Ringer Lactate Fluid Administration On Plasma Electrolytes, Acid Base Status And Renal Function In Cardiac Surgeries
Dr. Anjum Saiyed, Dr Reema Meena, Dr. Yogendra Singh
Department of Anaesthesiology S.M.S Medical College and Attached Hospitals, Jaipur, India
Article history:
Received: 14 June, 2019
Accepted: 25 June, 2019
Available Online: 02 June, 2022
Corresponding Author: Dr. Yogendra Singh
Dr. Anjum Saiyed, Dr Reema Meena, Dr. Yogendra Singh are awarded with Marie Curie Research Award- 2022 in Anaesthesia
Dr. Anjum Saiyed is Senior Professor, Dr Reema Meena is Senior Professor, Dr. Yogendra Singh is Post Graduate Student.
Abstract
Background Intraoperative fluid therapy is an integral part of anaesthesia management (1). Proper fluid therapy intra operatively will avoid hypovolemia and hypotension also maintains proper tissue perfusion and oxygen Patient who have to undergo cardiac surgery present a major challenge to the anaesthetist. No solution is ideal for fluid therapy in cardiac surgery. This study was carried out with the aim to compare and assess Balance salt solution and Ringer Lactate (RL) fluid administrations on plasma electrolytes, acid base status and renal function in patient undergoing cardiac surgeries on cardiopulmonary bypass. Method All patients were managed by standard institutional protocol and were randomly distributed in two groups according to fluid administered intravenously and priming solution used in cardiopulmonary bypass circuit. Total Cases [Group A(n=40) + Group B(n=40) = 80 ] Group A (n=40): received balanced salt solution intravenous (5ml/ kg /hour) and in the priming solution1500 ml + 6% hydroxy ethyl starch 500 ml (130/0.42 ) Group B (n=40): received RL intravenous (5ml/ kg /hour) and in the priming solution1500 ml + 6% hydroxy ethyl starch 500 ml (130/0.42). Primary variables recorded are plasma electrolytes (sodium,chloride ), lactate, bicarbonate, pH levels .Secondary variables blood glucose, serum creatinine levels, hemodynamic parameters (HR, MAP, CVP, Spo2) were noted at the interval mentioned Base line (T0), After anaesthesia induction (T1), Before going on bypass (T2 ), After coming of bypass (T3), At the end of surgery (T4) : 2 hr after surgery (T5) and 24 Hr after Ph ton 195 beginning of surgery (T6). Continuous data were summarized in from of mean and standard deviation. The difference in means was analyzed using student t- test. Count data were summarized in form of proportions. The difference in proportions was analyzed using Chi-Square test. The level of significance was kept 95% for all statistical analysis. Results There were no statistically significant differences in the demographic data between the two groups. In both the groups all variables were comparable at baseline. There is hyperchloremia in group B than group A at interval T5 and T6 The mean HCO3- was significantly higher in group A than group B at interval T3,T5,T6. The mean Lactate lavels were significantly higher in group B than group A at all the time intervals. The difference in mean blood glucose lavels was found to be statistically significantly high at T2, T4, T5, T6 time intervals. No complications with balanced salt solution and ringer lactate were encountered. Conclusion The balanced salt solution is better fluid than ringer lactate solution due to reduced incidence of hypercloramic metabolic acidosis and less increased level of serum glucose and lactate. Renal functions are better preserved in Balance salt solution.
Citation:
Dr. Anjum Saiyed, Dr Reema Meena, Dr. Yogendra Singh, 2022. Comparative Randomized Study Of Balanced Salt Solution And Ringer Lactate Fluid Administration On Plasma Electrolytes, Acid Base Status And Renal Function In Cardiac Surgeries. Photon Journal of Anesthesia. Photon 109, 194-204
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