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Comparison of the efficacy of 0.9% normal saline with balanced crystalloid (Plasmalyte) in maintaining the metabolic profile in head injury patients undergoing evacuation of acute subdural haematoma - A randomised controlled trial.
Sakkanan, Naveen Vivek; Swaminathan, Srinivasan; Bidkar, Prasanna Udupi; Vairappan, Balasubramaniyan; Sathiaprabhu, A; Dey, Ankita.
Afiliación
  • Sakkanan NV; Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
  • Swaminathan S; Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
  • Bidkar PU; Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
  • Vairappan B; Department of Biochemistry, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
  • Sathiaprabhu A; Department of Neurosurgery, Jawaharlal Institute of Post-graduate Medical Education and Research, Puducherry, India.
  • Dey A; Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Indian J Anaesth ; 68(6): 553-559, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38903257
ABSTRACT
Background and

Aims:

The choice of intravenous fluids is important in patients with traumatic brain injury (TBI), where large volumes may be required for resuscitation. Our study aimed to compare 0.9% normal saline (NS) with balanced crystalloid (Plasmalyte) in TBI patients in terms of metabolic and coagulation profile, brain relaxation score (BRS) and renal functions using serum urea, creatinine and urinary tissue inhibitor of metalloproteinases-2* insulin-like growth factor binding protein-7, [TIMP-2]*[IGFBP7], value to assess the risk of acute kidney injury.

Methods:

This randomised controlled trial on 90 TBI patients undergoing emergency craniotomy and subdural haematoma evacuation was conducted in a tertiary care institute. The patients were randomised to receive either NS (Group NS) or Plasmalyte (Group P) as the intraoperative maintenance fluid. The primary outcome measures included the potential of hydrogen (pH), base excess (BE) and chloride values from an arterial blood gas. The secondary outcomes were the coagulation profile, BRS and urinary [TIMP-2]*[IGFBP7]. The two groups' metabolic profile differences were analysed using two-way repeated analysis of variance. BRS was analysed using the Mann-Whitney U test. A P value < 0.05 was considered to be statistically significant.

Results:

The pH and chloride values were significantly higher, and the BE values were significantly lower in Group P compared to Group NS (P < 0.001). Brain relaxation and coagulation profiles were comparable between the two groups. Serum creatinine (P = 0.002) and urinary [TIMP-2]*[IGFBP7] (P = 0.042) were significantly higher in the NS group.

Conclusion:

Plasmalyte maintains a more favourable metabolic profile than NS in TBI patients without affecting brain relaxation adversely.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Indian J Anaesth Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Indian J Anaesth Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: India