Hyperchloremia and iatrogenic metabolic acidosis in patients undergoing elective supratentorial craniotomy for brain tumors. Balanced Salted Solution, Crystalloids, Hyperchloremia, Acid-Base Balance, Supratentorial Craniotomy
Conditions
Interventions
Patients will receive an isotonic balanced crystalloid solution (Top Balance) containing 98 mEq/L of chloride with acetate and gluconate buffers. The fluid will be administered intravenously to mainta
Experimental Drug,Active Comparator Drug
Isotonic Balanced Crystalloid Solution,Normal Saline
Sponsors
Sawanpracharak Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: 1. Patients aged between 18 and 65 years. 2. Physical status classification according to the American Society of Anesthesiologists (ASA) Class I, II, or III (with stable clinical conditions). 3. Patients scheduled for elective supratentorial craniotomy. 4. Anticipated surgical duration of more than 3 hours to ensure sufficient fluid administration for observable biochemical changes. 5. Patients who have provided voluntary written informed consent to participate in the study.
Exclusion criteria
Exclusion criteria: 1. Patients with pre-existing renal dysfunction, defined as a serum creatinine level more than 1.5 mg/dL or an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2. 2. Patients with severe pre-operative electrolyte imbalances, specifically a baseline serum chloride level more than 110 mEq/L or less than 95 mEq/L. 3. Patients diagnosed with severe heart failure or advanced liver cirrhosis. 4. Patients undergoing emergency surgery with hemodynamic instability or those requiring massive blood transfusions. 6. Patients who are pregnant.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Metabolic Acidosis Baseline before surgery, immediately after completion of surgery, and at 24 hours post-operatively Assessment of acid-base status through arterial blood gas analysis including pH, serum bicarbonate levels, and base excess | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of Hyperchloremia Baseline before surgery, at the end of surgery, and 24 hours after surgery Serum chloride levels measured by central laboratory,Renal function Baseline before surgery, at the end of surgery, and 24 hours after surgery Changes in Serum Creatinine levels,Acute Kidney Injury Baseline before surgery, at the end of surgery, and 24 hours after surgery Incidence of Acute Kidney Injury based on KDIGO criteria,Brain Relaxation Score During surgery at the time of dura opening Assessment by neurosurgeon using a 4 point scale at the time of dura opening,Serum Electrolyte variation Baseline before surgery, at the end of surgery, and 24 hours after surgery Serum Sodium and Potassium | — |
Countries
Thailand
Contacts
Public ContactChompoonik Jiemjitpolchai
Department of Anesthesiology, Sawanpracharak Hospital, Nakhonsawan, Thailand
Outcome results
None listed