Metabolic acidosis in traumatic patient with hemorrhagic shock Trauma, Hemorrhagic shock, Lactate Ringer'
Conditions
Interventions
Balanced salt solution as standard treatment,We use TOP balance solution, produced by Thai Otsuka pharmaceutical, Resemble the Plasmalyte-A solution which is Physiologic pH Low chloride balanced-salt
Active Comparator Drug,Experimental Drug
Lactate ringer'
s solution,Physiologic pH Low chloride balanced-salt solution
Sponsors
Department of surgery, Chiang Mai University
Eligibility
Sex/Gender
All
Age
20 Years to 60 Years
Inclusion criteria
Inclusion criteria: 1. Systolic blood pressure less than 90 mmHg or with sign of shock 2. Patient with blood lactate > 4 mmol/L or base excess < -2 3. Need immediate or emergency surgery within 120 minutes after arrival 4. Need for intubation due to severe metabolic acidosis 5. Need for blood transfusion or massive blood transfusion, defined by hemorrhagic shock grade 3 or 4
Exclusion criteria
Exclusion criteria: 1. Patient age < 20 or > 60 years old 2. Patient who not expected to survive to 72 hours 3. Moderate to severe head injury (Glasgow Coma Score <= 12) or evidence of intracranial hemorrhage 4. Pregnancy 5. Patient with documented chronic kidney disease; GFR <= 30 6. Patient who treated with or scheduled to have renal replacement therapy (including peritoneal dialysis and hemodialysis) 7. Patient with kidney transplantation 8. Cannot obtain consent form after intervention 9. Patient with chronic liver disease (Child-Pugh score>7) 10. Patient with documented or suspected of heart disease, congestive heart failure, pulmonary edema 11. Patient who is previously treated with lithium* which is contraindicated for studied fluid administration 12. Patient who at risk of hyperkalemia, including patients with severe renal impairment 13. Patients with or predisposed to hypermagnesemia, including patients with severe renal impairment and those patients receiving magnesium therapy (e.g., treatment of eclampsia and myasthenia gravis). 14. Patient with cardiac arrest either pre-hospital or upon arrival. 15. Patient who undergoes emergency thoracotomy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to normalize base excess 72 hours after resuscitation Base excess | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of electrolytes imbalance 72 hours post resuscitation blood test,incidence of adverse renal events 72 hour after resuscitation blood test ,Liver function test 72 hours post resuscitation blood test ,length of hospital and ICU stay, mortality rate in 30 days 30 days medical record,coagulopathy 72 hours after resuscitation blood test | — |
Countries
Thailand
Contacts
Public ContactPratchaya Wisutthithada
Chiangmai university
Outcome results
None listed