sodium-bicarbonate and Shock--Traumatic

The strategy for correction of metabolic acidosis and coagulation profile disorders in severe traumatic shock was adduced. There was established, that severe traumatic shock is characterized by prominent metabolic acidosis, the bases deficiency reduction, the lactate content in arterial blood enhancement, as well as ionized calcium in the blood serum, significant enhancement of the partially activated thromboplastin time and protrombin time, what witnesses the prominent coagulation disorders presence on the metabolic acidosis background. The "Soda-buffer" (manufactured by "Yuriya Pharm", Ukraine) preparation application in a complex of infusion-transfusion therapy permits in early terms to correct effectively the metabolic acidosis and coagulopathy signs in the injured persons, suffering severe trauma. Effective correction of metabolic acidosis and disorders of coagulation profile permits to lower trustworthily the erythrocytic mass volume transfused as well as fresh-frozen plasm while the infusion-transfusion therapy conduction.

Topics: Acidosis; Adolescent; Adult; APACHE; Blood Coagulation; Blood Coagulation Disorders; Buffers; Drug Therapy, Combination; Fluid Therapy; Humans; Hydrogen-Ion Concentration; Middle Aged; Shock, Traumatic; Sodium Bicarbonate; Trauma Severity Indices; Treatment Outcome; Young Adult

Biomarkers such as serum lactate, anion gap (AG), and base excess (BE) have been shown to be of use in determining shock in patients with seemingly normal vital signs. We seek to determine if these biomarkers can be used interchangeably in patients with trauma in the emergency setting based on their test characteristics and correlation to each other.. A prospective observational cohort study was undertaken at an urban level 1 trauma center. Baseline vital signs, point-of-care BE, AG, and serum lactate were recorded in all patients who presented for trauma. Correlation was determined by linear regression model. Overall test characteristics and relative risk were calculated.. One hundred patients were enrolled. The median age was 30 years (interquartile range, 24-42 years), and 89% were male. Fifty-three percent of injuries were blunt trauma. Pearson correlation of serum lactate to BE was -0.81 (r(2) = 0.66; 95% confidence interval [CI], 0.53-0.75; P < .001), that of BE to AG was -0.71 (r(2) = 0.5; 95% CI, -0.80 to -0.57; P < .01), and that for serum lactate to AG was 0.71 (r(2) = 0.5; 95% CI, 0.57-0.80; P < .01).. This study demonstrates that the biomarkers have similar test characteristics which may make them interchangeable as indicators for the presence of occult shock in patients with trauma. Lactate and BE correlate well with each other; however, AG was not as strongly correlated with either.

Topics: Acid-Base Equilibrium; Adult; Biomarkers; Emergency Service, Hospital; Female; Humans; Hydrogen-Ion Concentration; Lactic Acid; Linear Models; Male; Prospective Studies; ROC Curve; Shock, Traumatic; Sodium Bicarbonate; Vital Signs; Young Adult

Acute experiments on 67 adult dogs have demonstrated that infusions of lactasol in a dose of 25 ml/kg in the early period and in a dose of 50 ml/kg in the late period of shock are not efficacious enough. Injection of the increased amount of the saline in the early and late period of shock (up to 50 and up to 100 ml/kg, respectively) makes it possible to save from death almost all the animals. A conclusion is made that the therapeutic effect of lactasol depends on the amount of the saline injected and on the period of shock during which the saline is injected, as well as on the specific action of sodium lactate.

Topics: Animals; Bicarbonates; Calcium Chloride; Dogs; Female; Infusions, Parenteral; Lactates; Magnesium; Magnesium Chloride; Male; Potassium Chloride; Shock, Traumatic; Sodium Bicarbonate; Sodium Chloride