tailieunhanh - Báo cáo y học: " Sodium acetate infusion in critically ill trauma patients for hyperchloremic acidosis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: "Sodium acetate infusion in critically ill trauma patients for hyperchloremic acidosis | McCague et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2011 19 24 http content 19 1 24 SCANDINAVIAN JOURNALOF Et emergency medicine ORIGINAL RESEARCH Open Access Sodium acetate infusion in critically ill trauma patients for hyperchloremic acidosis Andrew McCague1 Mira Dermendjieva2 Ryan Hutchinson3 David TWong1 and Nguyen Dao2 Abstract Introduction Sodium acetate has been shown to cause hemodynamic instability when used as a hemodialysis buffer. The pattern of hemodynamic response to injury will be evaluated between those who received sodium acetate and those who did not. The primary purpose of the study is to analyze the effect of sodium acetate on hemodynamic parameters. Secondarily we looked at the effects on prevention and treatment of hyperchloremic metabolic acidosis. Methods The study arm was comprised of patients who had received sodium acetate infusions in place of normal saline between March 2005 and December 2009. A control arm was created based on matching three pretreatment variables injury severity score ISS pH - and base deficit - 3 . A retrospective chart review was performed for patients in both arms. Blood pressure arterial blood gas data and chemistry values were recorded for the time points of -6 -1 0 1 6 12 24 48 and 72 hours from start of sodium acetate infusion. Patients were excluded based on the following criteria patients who were given sodium bicarbonate within 48 hours of starting sodium acetate those given sodium acetate as a bolus non-trauma patients burn patients patients who expired within 24 hours of arrival to the ICU patients diagnosed with rhabdomyolysis and patients whose medical record could not be obtained. Results A total of 78 patients were included in the study 39 in the study arm and 39 in the control arm. There were no statistically significant drops in blood pressure within either group. The median pH between the two groups at the start of infusion was equal. Both groups .