The effect of pH of resuscitative fluids in treatment of severe XXXX .

@entity235 @entity520 @entity880 @entity548
Commercially available Ringer's lactate solution has a pH of approximately 6.5. In a situation such as shock, which is normally accompanied by a @entity520 , this additional acid load could have an adverse effect on resuscitation when massive amounts of fluid are required. We prepared a similar solution with a pH of 7.4 and compared the two solutions. Fourteen @entity235 were shocked according to a Wiggers' @entity548 model. Six @entity235 (43%) died during shock, 8 @entity235 survived the model, 4 were resuscitated over a 150-minute observation period to a pulmonary capillary wedge pressure (PCWP) of 8-12 mmHg with Ringer's lactate with a pH of 7.4. The cardiac output, @entity880 levels, amount of fluid required to maintain the PCWP, and arterial and mixed venous pH were measured at 30, 60, 90, 120, and 150 minutes. No significant differences were found except for occasionally higher arterial pH values in the group treated with Ringer's lactate with a pH of 7.4. There was no difference between the groups in any measurement at the end of the observation period or in survival. All @entity235 died within 12 hours of the end of the shock period. Our data indicate that the somewhat acidic pH of standard Ringer's lactate does not adversely affect the adequacy of resuscitation. There is no advantage to using Ringer's lactate with a pH of 7.4.
