Vandana N¹, Akshay MK²* and Bhupendra Khatri³

¹Postgraduate In Anaesthesiology, Department Of Anaesthesia, Vmmc And Safdarjung Hospital, New Delhi, India
²Senior Resident, Department of Orthopaedic, Cio- Vmmc Safdarjung Hospital, New Delhi, India
³Postgraduate In Orthopaedic, Department Of Orthopaedic, Cio-Vmmc Safdarjung Hospital, New Delhi, India

*Corresponding Author: Akshay MK, Senior Resident, Department of Orthopaedic, Cio- Vmmc Safdarjung Hospital, New Delhi, India.

Received: November 16, 2023; Published: January 24, 2024

Abstract

Introduction: The Intravenous fluids that are commonly used for early resuscitation in trauma patients are Isotonic saline and Ringer lactate. A new Intravenous fluid, Plasmalyte has been recently introduced for fluid resuscitation in trauma patients. In our study we compare the effects of commonly used Intravenous fluids such as Plasmalyte, Ringer lactate and Isotonic saline in traumatic patients

Material and Methods: AGE of 18-60 years of either gender admitted to emergency room for resuscitation with HR >120/ minute and Revised Trauma Score of 7-8(4 when weighing factor included). Three fluids Normal saline, Ringer lactate and Plasmalyte in150 adult trauma patients given and then blood, acid base parameters compared and then statistically analysed.

Discussion: Interventional comparative study comparing Normal saline, Ringer lactate and Plasmalyte in150 adult trauma patients of either gender admitted in emergency room in order to find out type of fluid used for fluid resuscitation, has any impact on acid -base balance, blood lactate level, biochemical parameters like blood urea, serum creatinine, serum electrolytes and hemodynamical parameters like Heart rate,spo2 and Revised trauma score.

Conclusion: The trauma patients resuscitated with Plasmalyte was found to have stable and normal acid base status, biochemical parameters and serum electrolyte levels.

Keywords: Crystalloids; Early Fluid Resuscitation; Polytrauma Patients; Emergency Room

References

1. Eliahou HE., et al. “Acetate and bicarbonate in the correction of uraemic acidosis”. British Medical Journal 45732 (2011): 399-401.
2. McFarlane C and Lee A. “A comparison of Plasmalyte 148 and 0. 9% saline for intra-operative fluid replacement”. Anaesthesia 49 (1994): 779-781.
3. Davies PG., et al. “Plasma acetate, gluconate and interleukin-6 profiles during and after cardiopulmonary bypass: a comparison of Plasma-Lyte 148 with a bicarbonate-balanced solution”. Critical Care 151 (2011): 21.
4. Williams EL., et al. “The effect of intravenous lactated ringer’s solution versus 0.9% sodium chloride solution on serum osmolality in human volunteers”. Anesthesia and Analgesia 88 (1999): 999-1003.
5. Prough DS and Bidani A. “Hyperchloremic metabolic acidosis is a predictable consequence of intraoperative infusion of 0. 9% saline”. Anesthesiology 90 (1999): 1247-1249.
6. Drummer C., et al. “Effects of an acute saline infusion on fluid and electrolyte metabolism in humans”. American Journal of Physiology 262 (2009): 744-754.
7. Liskaser FJ., et al. “Role of pump prime in the etiology and pathogenesis of cardiopulmonary bypass-associated acidosis”. Anesthesiology 93 (2000): 1170-1173.
8. Smith I., et al. “Base excess and lactate as prognostic indicators for patients admitted to intensive care”. Intensive Care Medicine 27 (2004): 74-83.
9. Cotton BA., et al. “The cellular, metabolic, and systemic consequences of aggressive fluid resuscitation strategies”. Shock 26 (2006): 115-121.
10. Noritomi DT., et al. “Impact of Plasma-Lyte pH 7. 4 on acid-base status and hemodynamics in a model of controlled hemorrhagic shock”. Clinics (Sao Paulo) 66 (2011): 1969-1974.
11. Morgan TJ and Venkatesh B. “Designing “balanced” crystalloids”. Critical Care and Resuscitation 54 (2003): 284-291.
12. Handy JM and Soni N. “Physiological effects of hyperchloraemia and acidosis”. British Journal of Anaesthesia101 (2008): 141-150.
13. Takil A., et al. “Early postoperative respiratory acidosis after large intravascular volume infusion of lactated ringer’s solution during major spine surgery”. Anesthesia and Analgesia 95 (2002): 294-298.
14. Weinberg L., et al. “The effects of plasmalyte-148 vs. Hartmann's solution during major liver resection: a multicentre, double-blind, randomized controlled trial”. Minerva Anestesiologica 81 (2015): 1288-1297.
15. Trivedi S., et al. “The Effect of Normal Saline and Plasmalyte on Acid-Base Status in Patients Undergoing Head-and-Neck Surgery with Free Flap Reconstruction: A Prospective, Observational Cohort Study”. Anesthesia Essays and Researches 15 (2021): 227-232.
16. Toomtong P and Suksompong S. “Intravenous fluids for abdominal aortic surgery”. Cochrane Database of Systematic Reviews (2010): 000991.
17. Potura E., et al. “An acetate-buffered balanced crystalloid versus 0.9% saline in patients with end-stage renal disease undergoing cadaveric renal transplantation: a prospective randomized controlled trial”. Anesthesia and Analgesia 120 (2015): 123-129.
18. Kim SY., et al. “Comparison of the effects of normal saline versus Plasmalyte on acid-base balance during living donor kidney transplantation using the Stewart and base excess methods”. Transplantation Proceedings 45 (2013): 2191-2196.
19. Oliver WD., et al. “Comparison of Plasma-Lyte A and Sodium Chloride 0.9% for Fluid Resuscitation of Patients with Diabetic Ketoacidosis”. Hospital Pharmacy 53 (2018): 326-330.
20. Kanbay M., et al. “Intravenous fluid therapy in accordance with kidney injury risk: when to prescribe what volume of which solution”. Clinical Kidney Journal 16 (2015): 684-692.
21. Chowdhury AH., et al. “A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte^® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers”. Annals of Surgery 256 (2012): 18-24.

Citation

Citation: Akshay MK. “Comparison of Three Types of Crystalloids for Choice in Early Fluid Resuscitation of Polytrauma Patients Admitted to Emergency Room".Acta Scientific Orthopaedics 7.2 (2024): 34-38.

Copyright

Copyright: © 2024 Akshay MK. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.