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Acid base and electrolyte changes after hypertonic saline (7.5%) infusion: a randomized controlled clinical trial
J A Kolsen-Petersen1, J O D Nielsen, E Tonnesen
1Department of Anaesthesia and Intensive Care, Viborg County Hospital, Viborg, Denmark. jaakp@dadlnet.dk
Summary
Hypertonic saline (7.5% NaCl) effectively treats shock and fluid deficits but can alter electrolytes. This study found that 7.5% NaCl infusion in women caused minor acid-base changes and increased plasma potassium.
Area of Science:
- Anesthesiology
- Nephrology
- Critical Care Medicine
Background:
- Hypertonic saline solutions are vital for managing hemorrhagic shock, septic shock, elevated intracranial pressure, and perioperative fluid deficits.
- However, their administration can lead to significant electrolyte and acid-base disturbances.
Purpose of the Study:
- To investigate the effects of a 7.5% NaCl infusion on plasma electrolytes and acid-base balance in normovolemic women.
- To compare these effects against a standard 0.9% NaCl infusion.
Main Methods:
- A randomized, double-blind study involving 14 fasting women undergoing hysterectomy.
- Infusion of 4 ml/kg of either 7.5% NaCl or 0.9% NaCl over 10 minutes.
- Serial blood sampling for electrolyte and acid-base analysis at multiple time points post-infusion.
Main Results:
- A median increase in plasma sodium (11 mmol/l) and chloride (14 mmol/l) immediately post-infusion of 7.5% NaCl.
- A significant increase in plasma potassium (0.3 mmol/l above baseline) after 1 hour.
- Minor decreases in pH (0.05) and base excess (1.9 mmol/l) were observed.
Conclusions:
- Infusion of clinically relevant doses of 7.5% NaCl can increase plasma potassium levels.
- The study indicates that 7.5% NaCl causes minor alterations in acid-base balance in normovolemic women.