第46回日本集中治療医学会学術集会

Presentation information

English Session

[EngO8] English Session8

Sat. Mar 2, 2019 4:10 PM - 5:10 PM 第11会場 (国立京都国際会館1F Room C-2)

Chair:Takaki Naito(Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Japan)

[EngO8-6] Effects of an isotonic balanced sodium solution and acetated Ringer’s solution on the incidence of hyponatremia in patients who have cardiac surgery

Sunthiti Morakul1, Naruemol Prachanpanich1, Piyarat Sittiwanna1, Sumethee Jiraratkul2 (1.Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand, 2.Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand)

Background: Perioperative hyponatremia is common in patients with cardiac surgery and may be directly responsible for adverse outcomes. Most perioperative fluid is balanced crystalloid, which is slightly hypotonic, such as acetated Ringer’s or lactated Ringer’s solution. However, there is an isotonic balanced crystalloid called Sterofundin, but chloride levels are still high in SF. In this study, we investigated the effect of Sterofundin versus acetated Ringer’s solution on the incidence of hyponatremia and hyperchloremia, and serum sodium and chloride levels.
Methods: We conducted a prospective, randomized, clinical trial in 82 patients aged 18 to 70 years who underwent elective cardiac surgery from August 2015 to November 2015.
Results: Three patients dropped out of the study because they received saline. A total of six (15.4%) patients in the acetated Ringer’s solution group and one (2.5%) patient in the Sterofundin group had hyponatremia (risk difference: −0.129; 95% CI: −0.252 to −0.006; P = 0.06). There were no between-group differences in serum sodium levels and the incidence of hyperchloremia between the groups. Serum chloride levels were significantly higher in the Sterofundin group than in the acetated Ringer’s solution group (108.1 ± 3.28 vs 106.3 ± 3.29 mmol/L; mean difference [95% CI]: −1.787 mmol/L [−3.281 to −0.294], P = 0.02).
Conclusions: The incidence of hyponatremia is not different between Sterofundin and acetated Ringer’s solution solutions during cardiac surgery. Serum chloride levels are increased with Sterofundin, but the incidence of hyperchloremia is not affected by Sterofundin.
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