[Postoperative metabolic acidosis: use of three different fluid therapy models].
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.
Tellan
Guglielmo
G
Dipartimento di Scienze Anestesiologiche, Medicina Critica e Terapia del Dolore, Università degli Studi La Sapienza, Roma.
Antonucci
Adriana
A
Marandola
Maurizio
M
Naclerio
Michele
M
Fiengo
Leslie
L
Molinari
Stefania
S
Delogu
Giovanna
G
D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000097:blood / Q000209:etiology / Q000628:therapy*; D000140:Acidosis, Lactic / Q000097:blood / Q000209:etiology / Q000628:therapy; D000368:Aged; D000465:Algorithms; D000471:Alkalosis / Q000097:blood / Q000139:chemically induced; D002712:Chlorides / Q000097:blood; D003082:Colectomy; D004338:Drug Combinations; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000628:therapy*; D000077325:Ringer's Lactate; D012965:Sodium Chloride / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D002712:Chlorides; D004338:Drug Combinations; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride