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BMC Infectious Diseases

, 8:50

First Online: 17 April 2008Received: 13 July 2007Accepted: 17 April 2008


BackgroundThe use of hypertonic crystalloid solutions, including sodium chloride and bicarbonate, for treating severe sepsis has been much debated in previous investigations. We have investigated the effects of three crystalloid solutions on fluid resuscitation in severe sepsis patients with hypotension.

MethodsNinety-four severe sepsis patients with hypotension were randomly assigned to three groups. The patients received the following injections within 15 min at initial treatment: Ns group n = 32, 5 ml-kg normal saline; Hs group n = 30, with 5 ml-kg 3.5% sodium chloride; and Sb group n = 32, 5 ml-kg 5% sodium bicarbonate. Cardiac output CO, systolic blood pressure, mean arterial pressure MAP, body temperature, heart rate, respiratory rate and blood gases were measured.

ResultsThere were no differences among the three groups in CO, MAP, heart rate or respiratory rate during the 120 min trial or the 8 hour follow-up, and no significant differences in observed mortality rate after 28 days. However, improvement of MAP and CO started earlier in the Sb group than in the Ns and Hs groups. Sodium bicarbonate increased the base excess but did not alter blood pH, lactic acid or HCO3 values; and neither 3.5% hypertonic saline nor 5% sodium bicarbonate altered the Na, K, Ca or Cl levels.

ConclusionAll three crystalloid solutions may be used for initial volume loading in severe sepsis, and sodium bicarbonate confers a limited benefit on humans with severe sepsis.

Trial registrationISRCTN36748319.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2334-8-50 contains supplementary material, which is available to authorized users.

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Autor: Zhi Xun Fang - Yu Feng Li - Xiao Qing Zhou - Zhen Zhang - Jin Song Zhang - Hai Ming Xia - Guo Ping Xing - Wei Ping 

Fuente: https://link.springer.com/

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