title: Impact of Plasma-Lyte pH 7.4 on acid-base status and hemodynamics in a model of controlled hemorrhagic shock.
abstract: OBJECTIVE
  Intravenous infusion of crystalloid solutions is a cornerstone of the treatment of hemorrhagic shock. However, crystalloid solutions can have variable metabolic acid-base effects, perpetuating or even aggravating shock-induced metabolic acidosis. The aim of this study was to compare, in a controlled volume-driven porcine model of hemorrhagic shock, the effects of three different crystalloid solutions on the hemodynamics and acid-base balance.
  
  
  METHODS
  Controlled hemorrhagic shock (40% of the total blood volume was removed) was induced in 18 animals, which were then treated with normal saline (0.9% NaCl), Lactated Ringer's Solution or Plasma-Lyte pH 7.4, in a blinded fashion (n = 6 for each group). Using a predefined protocol, the animals received three times the volume of blood removed.
  
  
  RESULTS
  The three different crystalloid infusions were equally capable of reversing the hemorrhage-induced low cardiac output and anuria. The Lactated Ringer's Solution and Plasma-Lyte pH 7.4 infusions resulted in an increased standard base excess and a decreased serum chloride level, whereas treatment with normal saline resulted in a decreased standard base excess and an increased serum chloride level. The Plasma-Lyte pH 7.4 infusions did not change the level of the unmeasured anions.
  
  
  CONCLUSIONS
  Although the three tested crystalloid solutions were equally able to attenuate the hemodynamic and tissue perfusion disturbances, only the normal saline induced hyperchloremia and metabolic acidosis.
authors.affiliation: Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Danilo Teixeira
authors.initials: DT
authors.lastname: Noritomi
authors.forename: Adriano José
authors.initials: AJ
authors.lastname: Pereira
authors.forename: Diogo Diniz Gomes
authors.initials: DD
authors.lastname: Bugano
authors.forename: Paulo Sergio
authors.initials: PS
authors.lastname: Rehder
authors.forename: Eliézer
authors.initials: E
authors.lastname: Silva
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects*; D000818:Animals; D000077324:Crystalloid Solutions; D004195:Disease Models, Animal; D004812:Epidemiologic Methods; D005942:Gluconates / Q000009:adverse effects; D006439:Hemodynamics / Q000187:drug effects*; D006863:Hydrogen-Ion Concentration; D007552:Isotonic Solutions / Q000009:adverse effects* / Q000145:classification; D015636:Magnesium Chloride / Q000009:adverse effects; D008297:Male; D011189:Potassium Chloride / Q000009:adverse effects; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000139:chemically induced / Q000188:drug therapy*; D019346:Sodium Acetate / Q000009:adverse effects; D012965:Sodium Chloride / Q000009:adverse effects; D013552:Swine
chemical_list: D000077324:Crystalloid Solutions; D005942:Gluconates; D007552:Isotonic Solutions; C012499:Plasma-lyte 148; D000077325:Ringer's Lactate; D015636:Magnesium Chloride; D012965:Sodium Chloride; D019346:Sodium Acetate; D011189:Potassium Chloride
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