Effect of rapidly infused crystalloids on acid-base status of dehydrated patients in the emergency department

Introduction

Dehydration is an important problem among patients admitted to the emergency department (ED). However, there has not yet been a consensus on the ideal fluid for these patients. This study was planned to evaluate the ideal crystalloid for the patients admitted to the ED who have symptoms of dehydration.

Methods

We conducted a randomized controlled trial that included 90 dehydrated patients. Three groups of patients each included 30 randomized for one of the solutions Lactated Ringer's, 0.9% NaCl or Isolyte^® (Eczacibasi-Baxter, Turkey). Solutions were infused at a rate of 20 ml/kg/hour for 2 hours. Venous blood sample pH, Na⁺, K⁺, Cl^-, and HCO₃^- levels were evaluated at 0, 1, and 2 hours.

Results

We detected a decrease in serum pH (7.406 to 7.365) and HCO₃^- (23.1 to 21.5) levels at the second hour in the 0.9% NaCl group. However, in the Isolyte^® group an increase in both serum pH (7.410 to 7.434) and HCO₃^- (23.4 to 24.4) levels were observed. In the Lactated Ringer's group, there was no significant change in serum pH and HCO₃^- levels. All changes were in the physiological range (Table 1).

Table 1

Conclusions

All three crystalloid solutions can be safely used for dehydrated patients and the best metabolic profile can be maintained in patients who receive Isolyte^®.