A comparison of Ringer's lactate and acetate solutions and resuscitative effects on splanchnic dysoxia in patients with extensive burns.
We compared the effects of Ringer's lactate (RL) and acetate (RA) solutions on parameters of splanchnic dysoxia such as PgCO(2) (PCO(2) of gastric mucosa) and pH(i) (pH of gastric mucosa) using a gastric tonometer, in addition to blood markers such as the serum arterial level of lactate, base excess, ketone body ratio, and antithrombin during the first 72h of the resuscitation period in patients with burns covering 30% or more of their body surface. A prospective study was conducted in the university tertiary referral centers. There were no significant differences in the average age, TBSA (total burn surface area), and resuscitative fluid volume during the first and second 24h between the two groups. In the RA group, PCO(2) gap values calculated employing the formula: PgCO(2)-PaCO(2) (arterial PCO(2)), and pH gap calculated by: pH(a) (arterial pH)-pH(i), improved to the normal ranges at 24 h postburn, which was significantly faster than in the RL group. On the other hand, there were no significant differences in blood parameters between the two groups over the course. These results suggest that fluid resuscitation with RA may more rapidly ameliorate splanchnic dysoxia, as evidenced by gastric tonometry, compared to that with RL.
Aoki
Katsunori
K
Department of Emergency Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan. dcc311@hama-med.ac.jp
Yoshino
Atsuto
A
Yoh
Kikuo
K
Sekine
Kazuhiko
K
Yamazaki
Motoyasu
M
Aikawa
Naoki
N
D000085:Acetates / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects; D002056:Burns / Q000503:physiopathology / Q000628:therapy*; D002245:Carbon Dioxide / Q000032:analysis*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005753:Gastric Mucosa / Q000098:blood supply / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D007552:Isotonic Solutions / Q000627:therapeutic use*; D007659:Ketones / Q000097:blood; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods*; D000077325:Ringer's Lactate; D013152:Splanchnic Circulation / Q000187:drug effects* / Q000502:physiology
D000085:Acetates; D000991:Antithrombins; D015415:Biomarkers; D007552:Isotonic Solutions; D007659:Ketones; D007773:Lactates; D000077325:Ringer's Lactate; D002245:Carbon Dioxide