Intraoperative Effects of Ringer's Solutions Incorporating Bicarbonate Precursors

Four modifications of Ringer's solution, three containing either acetate or lactate, were administered for 2 hours to patients undergoing major abdominal or head-neck surgery. Results were compared with one group of patients who received minimal amounts of intravenous 5 percent dextrose in water under similar conditions.Properly ventilated, moderately ill patients readily correct any acidotic changes occurring during brief operations. The amount of bicarbonate (HCO3) precursor supplied in commercial solutions is top small to be very effective. Of the precursors tested, acetate seemed to supply HCO3 most readily but may have limited use because of its vasodilating tendencies.Large volumes of multiple electrolyte solutions predictably stabilize blood pressure unless a vasodilator is present. We have found lactated solutions best for this purpose.

[1]  J. Y. Masuda,et al.  The pH and acidity of intravenous infusion solutions. , 1971, JAMA.

[2]  N Rietbrock,et al.  [Lactic acid]. , 1971, Deutsche medizinische Wochenschrift.

[3]  B. Rush,et al.  MORE LIBERAL USE OF A PLASMA EXPANDER: IMPACT ON A HOSPITAL BLOOD BANK , 1970 .

[4]  S. Humerfelt,et al.  The observer variation in the measurement of arterial blood pressure. , 2009, Acta medica Scandinavica.

[5]  G. Shires.  Fluid and electrolyte needs at operation. , 1968, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[6]  C. Moyer,et al.  A bioassay of treatment of hemorrhagic shock. I. The roles of blood, Ringer's solution with lactate, and macromolecules (dextran and hydroxyethyl starch) in the treatment of hemorrhagic shock in the anesthetized dog. , 1966, Archives of surgery.

[7]  R. Trudnowski.  Hydration with Ringer's lactate solution; its effectiveness in maintaining stable circulation during and after surgery. , 1966, JAMA.

[8]  E. Segal.  Acid-base metabolism. , 1966, Minnesota medicine.

[9]  R. Trudnowski,et al.  INTRAOPERATIVE FLUID THERAPY; RELATIONSHIP TO ANESTHETIC AND SURGICAL COMPLICATIONS. , 1964, New York state journal of medicine.

[10]  B. Scribner,et al.  Substitution of sodium acetate for sodium bicarbonate in the bath fluid for hemodialysis. , 1964, Transactions - American Society for Artificial Internal Organs.

[11]  M. Holliday.  A primer of water, electrolyte, and acid-base syndromes , 1962 .

[12]  D. Vere,et al.  Venous thrombosis during dextrose infusion. , 1960, Lancet.

[13]  B. Ferris,et al.  Clinical use of a nomogram to estimate proper ventilation during artificial respiration. , 1954, The New England journal of medicine.

[14]  J. Lattimer,et al.  Electrolyte solution approximating plasma concentrations with increased potassium for routine fluid and electrolyte replacement. , 1952, Journal of the American Medical Association.

[15]  G. Mudge,et al.  Sodium Acetate as a Source of Fixed Base.∗ , 1949, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[16]  R. Elman,et al.  THE EFFECTS OF LOSS OF GASTRIC AND PANCREATIC SECRETIONS AND THE METHODS FOR RESTORATION OF NORMAL CONDITIONS IN THE BODY , 1929, The Journal of experimental medicine.

[17]  C. Cori,et al.  GLYCOGEN FORMATION IN THE LIVER FROM d- AND l-LACTIC ACID , 1929 .

[18]  D. Richards,et al.  A vasodilator action of acetates , 1928, The Journal of physiology.