18
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Efecto de la fluido terapia endovenosa en los electrolitos y gases arteriales de pacientes ancianos hospitalizados. Estudio comparativo: Solución Hartmann y solución salina hipotónica. Translated title: Effect of intravenous therapy on the electrolytes and arterial blood gases of hospitalized elderly patients: A comparative study between Hartmann´s solution and hypotonic saline solution

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objetivos: Comparar el efecto de una solución de dextrosa hipotónica y de una solución isotónica (Hartmann) en los niveles séricos de electrolitos y el equilibrio ácido base en pacientes ancianos hospitalizados. Materiales y métodos: Se evaluaron prospectivamente a 18 pacientes mayores de 60 años hospitalizados en el departamento de Medicina del Hospital Nacional Cayetano Heredia que recibieron fluidos endovenosos al menos por 48 horas. El primer grupo (G1) recibió una solución de dextrosa al 5%, 71 mmol/L de ClNa y 27 mmol/L de cloruro de potasio. El segundo grupo (G2) recibió solución Hartmann, más una solución glucosada de 100 cc al 50% simultáneamente. Se controlaron los valores de los electrolitos y los gases sanguíneos a las 0, 24 y 48 horas de iniciada la observación. Resultados: Ambos grupos presentaron condiciones comparables al ingreso. A las 48 horas los valores del sodio para el G1 fueron 134,5±4,4 mEq/L y para el G2 140±2,4 mEq/L (p<0,01), el pH del G1 fue 7,32±0,07 y el del G2 fue 7,4±0,03 (p<0,01), y el bicarbonato fue 16,6±2,2 mEq/L para el G1 y 22,3±1,6 mEq/L para el G2 (p<0,001). La diferencia entre los valores a las 0 (delta) y 48 horas fueron: sodio -6,1±3,78(G1), 0,9±2,25(G2) en mEq/L, (p<0,001); potasio 0,01±0,43(G1), -0,61±0,56(G2) en mEq/L, (p<0,05); pH -0,09±0,07(G1), -0,01±0,04(G2), (p<0,01); bicarbonato -6,34±1,21(G1), -0,27±1,43(G2) en mEq/L, (p<0,001); pCO2 -6,25±5,33 (G1), 1,4±4,52(G2) en mmHg, (p<0,01). Conclusiones: Los pacientes ancianos hospitalizados que recibieron solución de dextrosa hipotónica, tuvieron niveles significativamente menores de sodio, pH, bicarbonato y pCO2 después de 48 horas comparados con quienes recibieron solución de Hartmann. No se observaron diferencias en los niveles de cloruro, pO2 y anion gap.(Rev Med Hered 2006;17:189-195).

          Translated abstract

          Objective: To compare the effect of hypotonic dextrose solution vs. isotonic Hartmann solution on serum electrolytes and acid-base equilibrium in elderly hospitalized patients. Patients and methods: Eighteen patients over 60-years old, admitted to medicine department of the Hospital Nacional Cayetano Heredia and received intravenous fluids during 48 hours, were prospectively evaluated. Control cohort received a solution of 5% dextrose, 71 mmol/L of sodium chloride, and 27 mmol/L of potassium chloride. Experimental cohort received Hartmann's solution plus 100 cc of 50% dextrose solution. The electrolytes and blood gas levels were measured at hours 0, 24, and 48. Results: Electrolyte levels and the acid-base equilibrium were similar for both cohorts at the beginning of study. After 48 hours we observed significant differences between cohorts in the sodium (G1=134.5±4.4, G2=140±2.4, p<0.01), pH (G1=7.32±0.07, G2=7.4±0.03, p<0.01), and bicarbonate (G1=16.6±2.2, G2=22.3±1.6, p<0.001) levels. The differences between the values at hours 0 and 48 (delta) were: sodium -6.1±3.78(G1), 0.9±2.25(G2) mEq/l, (p<0.001); potassium 0.01±0.43(G1), -0.61±0.56(G2) mEq/L, (p=0.05); pH -0.09±0.07(G1), -0.01±0.04(G2), (p<0.01); bicarbonate -6.34±1.21(G1), -0.27±1.43(G2) mEq/L, (p<0.001); pCO2 -6.25±5.33(G1), 1.4±4.52(G2) mmHg, (p<0.01). Conclusions: Elderly hospitalized patients who received hypotonic dextrose solution had significantly lower plasma sodium, pH, bicarbonate, and pCO2 levels after 48 hours of intravenous fluid therapy as compared with patients who received Hartmann's solution. No significant differences in chloride, pO2, and anion gap serum levels were observed. (Rev Med Hered 2006;17:189-195).

          Related collections

          Most cited references28

          • Record: found
          • Abstract: found
          • Article: not found

          Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin.

          We prospectively evaluated the frequency, cause, and outcome of hyponatremia (plasma sodium concentration, less than 130 meq/L), as well as the hormonal response to this condition, in hospitalized patients. Daily incidence and prevalence of hyponatremia averaged 0.97% and 2.48%, respectively. Two thirds of all hyponatremia was hospital acquired. Normovolemic states (so-called syndrome of inappropriate secretion of antidiuretic hormone) were the most commonly seen clinical setting of hyponatremia. The fatality rate for hyponatremic patients was 60-fold that for patients without documented hyponatremia. Nonosmotic secretion of vasopressin was present in 97% of hyponatremic patients in whom it was sought. In edematous and hypovolemic patients, plasma hormonal responses (increases in plasma renin activity and aldosterone and norepinephrine levels) were compatible with baroreceptor-mediated release of vasopressin. Hyponatremia is a common hospital-acquired electrolyte disturbance that is an indicator of poor prognosis. Nonosmotic secretion of arginine vasopressin is a major pathogenetic factor in this electrolyte disturbance.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Postoperative hyponatremic encephalopathy in menstruant women.

            To determine factors associated with the development of encephalopathy and with its clinical course in patients with postoperative hyponatremia. Consultation and referral services of two university medical centers and community hospitals. Case-control study (risk factors for encephalopathy) and cohort study (clinical course among patients with encephalopathy). Case patients included 65 adults with postoperative hyponatremic encephalopathy; controls included 674 adult patients who had postoperative hyponatremia without encephalopathy and who were selected from 76,678 consecutive adult surgical inpatients. Age, gender, menstrual status, neurologic symptoms, time to development and degree of hyponatremia, arterial blood gas determinations, serum chemistries, morbidity and mortality. Case patients included 40 women (62%) and 25 men (38%) (P > 0.05); controls included 367 women (54%) and 307 men (46%) (P > 0.1). Of the 34 case patients who developed permanent brain damage or died, 33 (97%) were women (P 0.1). Women and men are equally likely to develop hyponatremia and hyponatremic encephalopathy after surgery. However, when hyponatremic encephalopathy develops, menstruant women are about 25 times more likely to die or have permanent brain damage compared with either men or postmenopausal women.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Incidence and etiology of hyponatremia in an intensive care unit.

              To evaluate the incidence and causes of hyponatremia in intensive care unit (ICU) patients, retrospective and prospective studies were done. Hyponatremia was defined as a serum sodium concentration equal to or less than 134 mmol/l (134 mEq/l). Prospectively, 29.6% of patients displayed hyponatremia. Relevant data were obtained in twelve patients. Two patients did not have serum hypoosmolality. In the ten patients with serum hypoosmolality, urine osmolality was not maximally dilute and urine sodium concentration was greater than 30 mmol/l (30 mEq/l) suggesting inappropriate antidiuretic hormone secretion (SIADH). However, three patients exhibited suppressed ADH levels despite absence of maximal urinary dilution. The data suggest that hyponatremia is common in ICU patients and that renal diluting defects are frequent. Therefore, hypotonic fluid should be administered cautiously.
                Bookmark

                Author and article information

                Journal
                rmh
                Revista Medica Herediana
                Rev Med Hered
                Universidad Peruana Cayetano Heredia. Facultad de Medicina "Alberto Hurtado" (Lima, , Peru )
                1018-130X
                1729-214X
                October 2006
                : 17
                : 4
                : 189-195
                Affiliations
                [02] orgnameUniversidad Peruana Cayetano Heredia orgdiv1Servicio de Nefrología
                [01] orgnameUniversidad Peruana Cayetano Heredia orgdiv1Departamento de Medicina
                Article
                S1018-130X2006000400002 S1018-130X(06)01700402
                76fa9ecf-a174-458a-a4e3-646c568f94e1

                http://creativecommons.org/licenses/by/4.0/

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 7
                Product

                SciELO Peru

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Articulos Originales

                pacientes hospitalizados,elderly,Hartmann's solution,acid-base disorders,electrolyte disorders,Fluid therapy,ancianos,solución Hartmann,alteraciones ácido básicas,alteraciones electrolíticas,Fluido terapia,hospitalized patients

                Comments

                Comment on this article