West Eleanor, Pettitt Rob, Jones Ronald S, Cripps Peter J, Mosing Martina
School of Veterinary Science, University of Liverpool, Liverpool, UK.
Vet Anaesth Analg. 2013 Sep;40(5):482-93. doi: 10.1111/vaa.12021. Epub 2013 Feb 25.
To compare acid-base balance and incidence of hyperchloraemic metabolic acidosis following administration of three crystalloid solutions to dogs undergoing anaesthesia for orthopaedic surgery.
Prospective, randomised, clinical study.
Sixty dogs.
During a non-standardised anaesthetic, 0.9% saline (S), Hartmann's solution (H) or a polyionic glucose-free maintenance solution (M) was administered IV at 10 mL kg(-1) hour(-1) . Venous blood pH, PCO2 , PCV, total protein, urea, sodium, potassium and chloride concentrations were measured at induction of anaesthesia (T0) and after 2 hours of fluid therapy (T2). Base excess (BE), bicarbonate, corrected chloride concentration (corrCl), osmolality, change in plasma volume (PV) and strong ion gap (SIG) were calculated. Changes in variables within groups (1-sample Student's t-test/Wilcoxon signed rank test) and between groups (1-way anova/Kruskal-Wallis) were assessed. Data are presented as median (interquartile range). Significance was set at p < 0.05.
No significant differences existed between groups for pH, PCO2 , PCV, total protein, urea, potassium, corrCl, PV and SIG. Potassium significantly increased in all groups. Significant differences existed between groups S and M for BE, sodium, chloride, bicarbonate and osmolality, and between groups H and M for sodium and osmolality. Chloride concentration significantly changed from 116 (114-117) to 117 (116-119) mmol L(-1) in group S, 116 (115-118) to 115 (113-117) mmol L(-1) in group H and 116 (115-118) to 114 (113-118) mmol L(-1) in group M. In groups H and M, sodium and osmolality decreased, and BE and bicarbonate concentration increased significantly. Plasma volume increased by 28 (14-44)%, 25 (5-40)% and 24 (13-33)% in groups S, H and M, respectively.
Hyperchloraemic metabolic acidosis did not develop after intraoperative 0.9% saline, Hartmann's solution or maintenance solution at 10 mL kg(-1) hour(-1) for 2 hours in dogs undergoing elective orthopaedic surgery. Bicarbonate and BE increased after Hartmann's and maintenance solutions. Increases in potassium concentration were unexplained.
比较在接受骨科手术麻醉的犬中,给予三种晶体溶液后酸碱平衡及高氯性代谢性酸中毒的发生率。
前瞻性、随机、临床研究。
60只犬。
在非标准化麻醉期间,以10 mL·kg⁻¹·小时⁻¹的速度静脉输注0.9%生理盐水(S组)、复方氯化钠溶液(H组)或无葡萄糖的多离子维持液(M组)。在麻醉诱导时(T0)和液体治疗2小时后(T2)测量静脉血pH值、二氧化碳分压(PCO₂)、红细胞压积(PCV)、总蛋白、尿素、钠、钾和氯浓度。计算碱剩余(BE)、碳酸氢盐、校正氯浓度(corrCl)、渗透压、血浆容量变化(PV)和强离子间隙(SIG)。评估组内变量变化(单样本t检验/威尔科克森符号秩检验)和组间变量变化(单因素方差分析/克鲁斯卡尔-沃利斯检验)。数据以中位数(四分位间距)表示。显著性设定为p < 0.05。
各组间pH值、PCO₂、PCV、总蛋白、尿素、钾、corrCl、PV和SIG无显著差异。所有组的钾均显著升高。S组和M组在BE、钠、氯、碳酸氢盐和渗透压方面存在显著差异,H组和M组在钠和渗透压方面存在显著差异。S组氯浓度从116(114 - 117)mmol/L显著变为117(116 - 119)mmol/L,H组从116(115 - 118)mmol/L变为115(113 - 117)mmol/L,M组从116(115 - 118)mmol/L变为114(()113 - 118)mmol/L。在H组和M组中,钠和渗透压降低,BE和碳酸氢盐浓度显著升高。S组、H组和M组的血浆容量分别增加了28(14 - 44)%、25(5 - 4)%和24(13 - 33)%。
在接受择期骨科手术的犬中,术中以10 mL·kg⁻¹·小时⁻¹的速度输注0.9%生理盐水、复方氯化钠溶液或维持液2小时后,未发生高氯性代谢性酸中毒。给予复方氯化钠溶液和维持液后,碳酸氢盐和BE升高。钾浓度升高的原因不明。