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D. . Kazantsev1, .S. Popov1, .V. Strygin2,3, .I. orkovin2,3, . . Tolkachev2,4
ФГБОУ ВО «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской Федерации, 1кафедра анестезиологии и реаниматологии с трансфузиологией ФУВ; 2кафедра фундаментальной медицины и биологии; ГБУ «Волгоградский медицинск
Infusion of crystalloids solutions is one of most frequently administered types of therapeutic interventions in patients undergoing surgical operations. The goal of the current prospective randomized clinical study was to compare the effects of acetate-based balanced solution Ionosteril® (group 1) and non-balanced 0,9% NaCl solution (group 2) on acid-base balance and hemodynamic stability within 48 hours of intra- and post-operative period in patients undergoing abdominal surgical operations. Levels of chloremia and base excess (BE) were set as primary end-point indicating the severity of metabolic acid-base disturbances. Hemodynamic parameters and kidney function markers (creatinine, cystatin C) was also assessed in dynamics. The infusion of acetate-based balanced solution resulted in much less severe acid-base disturbances, particularly more stable pH and serum bicarbonate levels with no signs of base deficit. Patients administered 0,9% NaCl solution had statistically higher level of hyperchloremia and concurrent metabolic acidosis. Based on the levels of cystatin C as biomarker of early kidney damage, intra- and post-operation kidney function seem to be more stable in the group of patients treated with Ionosteril®. Therefore admistration of acetate-based crystalloid solution appears to be more rational choice for prevention of hypovolemia and maintaining hemodynamic stability in patients undergoing abdominal surgical procedures.
crystalloid solution, acid-base balance, hemodynamics, infusion therapy, hyperchloremia, metabolic acidosis.
Казанцев Дмитрий Андреевич – ассистент кафедры анестезиологии и реаниматологии с трансфузиологией ФУВ ВолгГМУ, зав. отделением реанимации и интенсивной терапии ГБУЗ ВОКБ № 1, е-mail: kdaorit@gmail.com