Normal saline versus lactated Ringer's solution for intraoperative fluid management in XXXX undergoing abdominal aortic aneurysm repair: an outcome study.

@entity1 @entity190 @entity3157 @entity260 @entity520 @entity4361
@entity520 and changes in serum osmolarity are consequences of 0.9% @entity4361 ( @entity4361 ) solution administration. We sought to determine if these physiologic changes influence @entity1 outcome. @entity1 undergoing aortic reconstructive surgery were enrolled and were randomly assigned to receive lactated Ringer's (LR) solution (n = 33) or @entity4361 (n = 33) in a double-blinded fashion. Anesthetic and fluid management were standardized. Multiple measures of outcome were monitored. The @entity4361 @entity1 developed a hyperchloremic @entity520 and received more @entity3157 therapy (30 +/- 62 mL in the @entity4361 group versus 4 +/- 16 mL in the LR group; mean +/- SD), which was given if the base deficit was greater than -5 mEq/L. The @entity4361 @entity1 also received a larger volume of platelet transfusion (478 +/- 302 mL in the @entity4361 group versus 223 +/- 24 mL in the LR group; mean +/- SD). When all blood products were summed, the @entity4361 group received significantly more blood products (P = 0.02). There were no differences in duration of mechanical ventilation, intensive care unit stay, hospital stay, and incidence of complications. When @entity4361 was used as the primary intraoperative solution, significantly more @entity520 was seen on completion of surgery. This @entity520 resulted in no apparent change in outcome but required larger amounts of @entity3157 to achieve predetermined measurements of base deficit and was associated with the use of larger amounts of blood products. These changes should be considered when choosing fluids for surgical procedures involving extensive @entity190 and requiring extensive fluid administration. IMPLICATIONS: Predominant use of 0.9% saline solution in major surgery has little impact on outcome as assessed by duration of mechanical ventilation, intensive care unit stay, hospital stay, and @entity260 , but it does appear to be associated with increased perioperative @entity190 .
