title: Normal saline versus balanced-salt solution as intravenous fluid therapy during neurosurgery: effects on acid-base balance and electrolytes.
abstract: BACKGROUND
  This prospective, randomized controlled study compared the changes in acid-base balance and serum electrolytes with the use of intravenous balanced and non-balanced crystalloid solutions intraoperatively during elective neurosurgery.
  
  
  METHODS
  Thirty consented adult patients who underwent craniotomy were randomly allocated into two groups of 15 patients each. The non-balanced group received 0.9% normal saline while the balanced group received Sterofundin®ISO as the intraoperative fluid for maintenance. Biochemical indices for acid-base balance and serum electrolytes were analyzed periodically.
  
  
  RESULTS
  In the non-balanced group, significant changes were noted in the pH, base excess and bicarbonate values over time compared to its respective baseline values (P<0.01). Four patients (27.7%) also developed a pH<7.35 and 5 patients (33.3%) developed marked acidosis with base excess <-4.0 at the end of surgery. Both mean sodium and chloride levels were also significantly higher compared to its baseline values respectively (142.6±2.4 versus 138±2.7 mmol/L, P<0.01 and 105.7±4.1 versus 113.2±3.0 mmol/L (P<0.01).
  
  
  CONCLUSIONS
  A balanced solution (Sterofundin®ISO) provided significantly better control over acid-base balance, sodium and chloride levels when used as intraoperative fluid maintenance and replacement during elective neurosurgery.
authors: Department of Anaesthesiology and Intensive Care, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors: Mohamed
authors: M
authors: Hafizah
authors: Department of Anaesthesiology and Intensive Care, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors: Chian Y
authors: CY
authors: Liu
authors: Department of Anaesthesiology and Intensive Care, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia - ooi.joanna@yahoo.com.
authors: Joanna S
authors: JS
authors: Ooi
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology*; D000328:Adult; D003399:Craniotomy / Q000379:methods*; D004573:Electrolytes / Q000097:blood*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009930:Organic Chemicals / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D012965:Sodium Chloride / Q000627:therapeutic use*
chemical_list: D004573:Electrolytes; D009930:Organic Chemicals; D012965:Sodium Chloride; C052337:sterofundin