Normal saline versus balanced-salt solution as intravenous fluid therapy during neurosurgery

Effects on acid-base balance and electrolytes

Research output: Contribution to journalArticle

7 Citations (Scopus)

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 nonbalanced 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.

Original languageEnglish
Pages (from-to)263-270
Number of pages8
JournalJournal of Neurosurgical Sciences
Volume61
Issue number3
DOIs
Publication statusPublished - 1 Jun 2017

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Acid-Base Equilibrium
Fluid Therapy
Neurosurgery
Electrolytes
Salts
Sodium Chloride
Maintenance
Craniotomy
Bicarbonates
Acidosis
Serum

Keywords

  • Acid-Base Equilibrium
  • Electrolytes
  • Infusions, Intravenous
  • Neurosurgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

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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 nonbalanced group received 0.9{\%} normal saline while the balanced group received Sterofundin{\circledR}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{\circledR}ISO) provided significantly better control over acid-base balance, sodium and chloride levels when used as intraoperative fluid maintenance and replacement during elective neurosurgery.",
keywords = "Acid-Base Equilibrium, Electrolytes, Infusions, Intravenous, Neurosurgery",
author = "Mohamed Hafizah and Liu, {Chian Yong} and {Su Min}, {Ooi Joanna}",
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AU - Liu, Chian Yong

AU - Su Min, Ooi Joanna

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N2 - 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 nonbalanced 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.

AB - 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 nonbalanced 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.

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