Efficacy of bicarbonate Ringer′s solution for early fluid resuscitation in patients with septic shock
10.3760/cma.j.cn131073.20240126.01217
- VernacularTitle:碳酸氢钠林格液用于脓毒症休克患者早期液体复苏的效果
- Author:
Xuefang LIU
1
;
Wenbin TIAN
1
;
Ning YU
1
;
Xiaoxiao ZHANG
1
;
Long BAI
1
;
Ya LIU
1
Author Information
1. 河北医科大学第二医院麻醉ICU，石家庄 050000
- Publication Type:Journal Article
- Keywords:
Sodium bicarbonate;
Sodium lactate;
Ringer′s solution;
Shock, septic;
Fluid resuscitation
- From:
Chinese Journal of Anesthesiology
2024;44(12):1485-1489
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the Efficacy of bicarbonate Ringer′s solution (BRS) for early fluid resuscitation in patients with septic shock.Methods:In this prospective cohort study, 80 patients of either sex with septic shock, aged 18-80 yr, with a body mass index of 18-30 kg/m 2, who required early fluid resuscitation at the Anesthesiology and Intensive Care Unit of the Second Hospital of Hebei Medical University from April 2021 to April 2023, were included and divided into lactated Ringer′s solution group (LR group, n=40) and bicarbonate Ringer′s solution group (BR group, n=40). After the corresponding crystalloid solution 30 ml/kg was intravenously infused over 3-6 h for resuscitation, vasopressor drugs were used to achieve the goal of resuscitation: central venous pressure 8-12 mmHg, mean arterial pressure≥65 mmHg, urine volume> 0.5 ml·kg -1·h -1, the superior vena cava oxygen saturation≥0.7. Arterial blood gas analysis was performed immediately after the diagnosis of septic shock (before resuscitation), immediately after the end of fluid resuscitation and at 6 h after the diagnosis. The vasoactive-inotropic score was calculated. The plasma syndecan-1 concentration and serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and creatinine (Cr) concentrations were measured by enzyme-linked immunosorbent assay before resuscitation and at 24 h after resuscitation. The 28-day all-cause mortality was recorded. Results:The pH value and HCO 3- concentration were significantly increased immediately after the end of resuscitation in BR group compared with the baseline before resuscitation ( P<0.05). Compared with LR group, the HCO 3- concentration, normal rate of lactic acid and improvement rate of AST were significantly increased immediately after the end of resuscitation ( P<0.05), and no significant change was found in the other parameters of blood gas analysis, vasoactive-inotropic score, plasma syndecan-1 concentrations, concentrations of ALT, AST and Cr in serum, improvement rate of ALT, improvement rate of Cr, and 28-day all-cause mortality in BR group ( P>0.05). Conclusions:Bicarbonate Ringer′s solution is superior to lactated Ringer′s solution for early fluid resuscitation in the patients with septic shock.
