Crystalloid strong ion difference determines metabolic acid-base change during acute normovolaemic haemodilution

Morgan, Thomas J., Venkatesh, Balasubramanian and Hall, Jonathan (2004) Crystalloid strong ion difference determines metabolic acid-base change during acute normovolaemic haemodilution. Intensive Care Medicine, 30 7: 1432-1437. doi:10.1007/s00134-004-2176-x


Author Morgan, Thomas J.
Venkatesh, Balasubramanian
Hall, Jonathan
Title Crystalloid strong ion difference determines metabolic acid-base change during acute normovolaemic haemodilution
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 0342-4642
Publication date 2004-07-01
Sub-type Article (original research)
DOI 10.1007/s00134-004-2176-x
Open Access Status
Volume 30
Issue 7
Start page 1432
End page 1437
Total pages 6
Editor L. Brochard
Place of publication Germany
Publisher Springer-Verlag
Language eng
Subject CX
321009 Intensive Care
730199 Clinical health not specific to particular organs, diseases and conditions
Abstract Objective. To study the acid-base effects of crystalloid strong ion difference (SID) during haemodilution. Design. Prospective in vivo study. Setting. University laboratory. Subjects. Anaesthetised, mechanically ventilated Sprague-Dawley rats. Interventions. Rats were studied in seven groups of three. Each group underwent normovolaemic haemodilution with one of seven crystalloids, with SID values from 0 to 40 mEq/l. Six exchanges of 9 ml crystalloid for 3 ml blood were performed. Measurements and main results. [Hb] fell from 142+/-17 to 44+/-10 g/l (p<0.0001). Final plasma [lactate] was 1.1+/-0.6 mmol/l. Final standard base excess values ranged from -8 to +7 mmol/l, and were directly correlated with crystalloid SID (R-2=0.91). By linear regression, the SID of a crystalloid balanced to maintain standard base excess=0 mmol/l was 23.7 mEq/l. Dilutions 2-5 produced similar results. Conclusions. There is a linear relationship between crystalloid SID and post-dilutional metabolic acid-base status. The SID of a crystalloid balanced for normovolaemic haemodilution is 24 mEq/l. These principles are applicable in designing fluids for volume resuscitation, acute normovolaemic haemodilution and cardio-pulmonary bypass.
Keyword Critical Care Medicine
Acid-base
Balanced Crystalloid
Haemodilution
Strong Ion Difference
Lactated Ringers Solution
0.9-percent Saline
Resuscitation
Replacement
Hemorrhage
Infusion
Chloride
Etiology
Rats
Q-Index Code CX

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 15:10:14 EST