Sodium bicarbonated Ringer's solution effectively improves coagulation function and lactic acid metabolism in patients with severe multiple injuries and traumatic shock.
MA Jianzhong, Sheng-Jin Han, Xiaolin Liu, Zhengwu Zhou
Abstract
OBJECTIVE: To explore the effect of sodium bicarbonated Ringer's solution on the coagulation function and the lactic acid metabolism in patients with severe multiple injuries and traumatic shock. METHODS: A prospective, randomized controlled study was designed to enroll 50 patients with severe multiple injuries and traumatic shock. The enrolled patients were randomly assigned into a Test group (n=25) or a Control group (n=25), which received restrictive fluid resuscitation with sodium bicarbonated Ringer's solution or sodium lactated Ringer's solution, respectively. The success rate of rescue, the changes in coagulation function indices, lactic acid level, arterial blood pH level, hemorheological indices, blood pressure and heart rate before and after resuscitation, as well as the shock-related complications were observed. RESULTS: The coagulation function of the Test group was significantly improved after resuscitation as compared with the Control group (P<0.05). After resuscitation, the Test group had significantly lower lactic acid level and significantly higher pH level than those of the Control group (both P<0.05). The hemorheological indices of the Test group were improved more significantly after resuscitation as compared with those of the Control group (P<0.05). There was no significant difference in the success rate of rescue between the Test group and the Control group (92.0% vs. 80.0%; P>0.05), but the total incidence of complications in the Test group was significantly lower than that in the Control group (16.0% vs. 56.0%; P<0.01). CONCLUSION: Sodium bicarbonated Ringer's solution is effective in early resuscitation for patients with severe multiple injuries and traumatic shock through improving the coagulation function and lactic acid metabolism, reducing the risk of related complications and improving the clinical outcome in patients.