Comparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metab... - 0 views
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NS contains 154 mM Na+ and Cl-, with an average pH of 5.0 and osmolarity of 308 mOsm/L.
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LR solution has an average pH of 6.5, is hypo-osmolar (272 mOsm/L), and has similar electrolytes (130 mM Na+, 109 mM Cl-, 28 mM lactate, etc.) to plasma
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There were no significant differences between LR and NS groups in fibrinogen concentrations or platelet count
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Bicarbonate HCO3- levels were decreased by hemorrhage but returned to pre-hemorrhage values by 3 h after LR resuscitation, whereas no return was observed with NS resuscitation
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PT was similarly prolonged by resuscitation with LR (from 11.2 ± 0.2 sec at baseline to 12.1 ± 0.2 sec at 6 h) and NS
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Plasma aPTT was also similarly prolonged by resuscitation with LR (from 17.1 ± 0.5 sec baseline to 20.1 ± 1.2 sec at 6 h) or NS
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NS resuscitation resulted in better oxygen delivery and oxygen delivery-to-oxygen demand ratio as an index of oxygen debt
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LR resuscitation returned BE and bicarbonate to pre-hemorrhage levels within 3 h, but no return of BE or bicarbonate was observed for 6 hr with NS resuscitation
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current blood bank guidelines state that LR should not be mixed with blood to prevent the risk of clot formation from calcium included in LR
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LR resuscitation should not be given with blood through the same iv-line and crystalloids should be avoided in patients with blood transfusion
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PT and aPTT were prolonged for 6 h after hemorrhage and resuscitation, suggesting a hypocoagulable states
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we suspected that the blood pressure after NS resuscitation would be lower than that of LR due to its vasodilator effects
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NS required a larger resuscitation volume and was associated with poor acid base status and elevated serum potassium in this model
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NS required 50% more volume and was associated with a higher cardiac output and lower peripheral resistance, as compared to LR resuscitation
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an elevation of K+ was observed at 6 h post NS resuscitation, while no change of K+ was observed after LR resuscitation