Fluid Comparison in Post-op Severe TBI: Acid-Base and Electrolytes
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment
Year: 2017 | Doi: 10.21315/mjms2017.24.5.9
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
In neurosurgery and neuro-intensive care, maintaining proper fluid balance is essential to prevent complications such as cerebral edema. Normal saline (NS) is commonly used due to its iso-osmolarity but has drawbacks, including the risk of hyperchloremic metabolic acidosis with prolonged infusion. An alternative is the use of balanced fluids (BF), which contain complete electrolyte content and are more physiologically compatible. This study seeks to compare the effects of NS and BF (Sterofundin® ISO) on electrolyte and acid-base balance in post-operative patients with severe traumatic brain injury (TBI) within the neuro-ICU.
Effects of Fluid Type on Electrolyte and Acid-Base Balance
The results indicated significant differences between the two fluid therapies. The NS group exhibited lower base excess and bicarbonate levels, alongside higher chloride and lower potassium levels compared to the BF group at 24 hours post-infusion. Specifically, the BF approach maintained higher levels of calcium and magnesium while showing a trend toward improved acid-base status, reflected in less hyperchloremia and metabolic acidosis. Though both fluid types resulted in hyperchloremia, the BF group demonstrated a more stable electrolyte profile and minimized the incidence of hypokalemia and metabolic acidosis.
Conclusion
In summary, the use of balanced fluid therapy showed superior effectiveness in maintaining electrolyte levels and reducing risks associated with hyperchloremic metabolic acidosis compared to normal saline. The findings underscore the importance of choosing appropriate fluid management strategies in critical care settings, particularly for patients at risk of electrolyte imbalances after surgical interventions. These results support the implementation of balanced fluids in the post-operative management of severe TBI patients to promote better clinical outcomes.
FAQ section (important questions/answers):
What are the issues with normal saline in neurosurgery?
Normal saline (NS) lacks other electrolytes and can cause hyperchloremic metabolic acidosis with prolonged use, making it less desirable in neurosurgery and neuro-intensive care settings.
What is the objective of comparing balanced fluid and normal saline?
The study aimed to compare electrolyte and acid-base changes in post-operative severe traumatic brain injury patients receiving either normal saline or a balanced fluid (Sterofundin® ISO) to determine which is more beneficial.
How did balanced fluid therapy affect electrolyte levels compared to NS?
Balanced fluid therapy maintained higher levels of calcium and magnesium while reducing hyperchloremia and hypokalemia compared to normal saline, indicating its superiority in managing electrolyte balance over 24 hours.
What conclusion was drawn about fluid therapy for TBI patients?
Balanced fluid therapy was found to be more effective in maintaining electrolyte levels and reducing hyperchloremic metabolic acidosis in postoperative traumatic brain injury patients compared to normal saline therapy.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Fluid Comparison in Post-op Severe TBI: Acid-Base and Electrolytes”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In research papers, tables are essential for organizing data and presenting results in a clear, concise format. They allow readers to quickly compare and interpret findings, such as demographics or outcomes. In this study, tables summarize key parameters and statistical analyses, aiding in understanding the effects of fluid therapy on patients.
2) Study (Studying):
A study refers to a systematic investigation aimed at answering specific research questions. In the context of medical research, it often examines the effects of treatments or interventions on patient outcomes. This study focuses on comparing the impact of balanced fluids versus saline on electrolyte and acid-base status in TBI patients.
3) Blood:
Blood is a vital fluid in the body, responsible for transporting oxygen, nutrients, hormones, and waste products. Monitoring blood parameters, such as electrolyte levels, pH, and base excess, is crucial in clinical settings, especially in neurocritical care, as deviations can indicate complications or guide therapeutic interventions.
4) Post:
The term 'post' in medical research typically refers to the period following a specific event or treatment, such as surgery. In this study, 'post-operative' indicates assessments and interventions applied after surgical procedures on patients with traumatic brain injury, highlighting the significance of recovery monitoring and fluid management in the ICU.
5) Medicine:
Medicine encompasses the science of diagnosing, treating, and preventing diseases. It draws on biology, chemistry, and various subspecialties to enhance patient care. Understanding the principles of fluid therapy, as investigated in this study, is fundamental in modern medicine to optimize recovery and outcomes, particularly in critically ill patients.
6) Rules:
Rules in a research context refer to the guiding principles or protocols established for conducting and analyzing studies. These ensure ethical treatment of participants and the integrity of the data collected. Adhering to rules is crucial in ensuring the validity and reliability of the findings in this fluid therapy study.
7) Edema (Oedema):
Edema is the medical term for swelling caused by excess fluid trapped in the body's tissues. It is a critical concern in neurosurgery and can exacerbate conditions like traumatic brain injury. Managing fluid balance is crucial to prevent edema and maintain optimal intracranial pressure and patient outcomes post-surgery.
8) Repair:
Repair refers to the restoration of function or structure, particularly after injury or surgery. In the context of this study, it implies the surgical correction of traumatic brain injuries. Understanding fluid management's role in recovery is vital for enhancing the healing process in post-operative patients in critical care.
9) Water:
Water is an essential component of bodily fluids and plays a crucial role in maintaining homeostasis, electrolyte balance, and physiological functions. In clinical settings, fluid therapy involves managing water intake to prevent dehydration or overload, particularly following surgeries, as imbalances can significantly impact recovery and health outcomes.
10) Calculation:
Calculation in medical research often involves determining dosages, fluid requirements, or interpreting statistical results. Accurate calculations are vital for effective treatment planning and safe patient management. This study employs specific fluid calculation methods to ensure appropriate hydration and electrolyte management for patients post-traumatic brain injury.
11) Sharman (Sarma, Sharma, Sarman):
Sharma may refer to an author or contributor involved in the study. In academic papers, proper attribution to authors is essential, as it acknowledges their intellectual contributions, expertise, and efforts in the research. Recognition of collaborators, including Sharma, is vital for the credibility and accountability of the research findings.
12) Kumar:
Kumar is likely another contributing author in this research. The inclusion of multiple authors suggests a collaborative effort, reflecting diverse expertise in the study's design and analysis. Acknowledging Kumar's contribution is necessary for understanding the development, implications, and advancements in the field of neurocritical care addressed in the study.
13) Jacob:
Jacob is presumably another author associated with the study, reflecting collaborative research efforts in the field. Author recognition is significant in academic writing as it establishes accountability for the research outcomes. Including Jacob's contribution emphasizes the shared responsibility in exploring fluid therapy's impact on post-operative patient care.
14) Measurement:
Measurement in the context of this study involves quantifying various parameters such as electrolytes, blood gases, and acid-base balance. Accurate measurements are critical for evaluating the effectiveness of the fluid therapy being studied. They provide insights into patient status, guiding further treatment decisions and improving overall health outcomes in critical care.
15) Discussion:
Discussion sections in research papers interpret data, contextualize findings, and explore their implications. This segment is crucial for explaining the relevance of the results and how they contribute to existing knowledge. It enables authors to articulate the significance of their study, address limitations, and propose future research directions based on their findings.
16) Developing:
Developing refers to the process of improvement or advancement, particularly in medical research. In this study, it may relate to understanding how balanced fluid therapy can enhance patient outcomes, paving the way for better clinical practices in managing traumatic brain injury and optimizing care in neurocritical settings.
17) Bleeding:
Bleeding is a significant concern during and after surgical procedures, particularly in neurosurgery, where it can lead to complications. Managing blood loss and fluid balance is critical for patient recovery. Understanding the impact of different fluid therapies on bleeding risk can inform clinical practices and treatment strategies in critically ill patients.
18) Allergy:
An allergy is an adverse immune response to substances known as allergens. In the context of this study, understanding patient allergies is crucial for selecting appropriate fluid therapies. Any allergic reactions can complicate treatment planning, necessitating careful screening of patients before administering any medications or fluids post-surgery.
19) Vena:
Vena refers to veins, the blood vessels that carry blood towards the heart. Monitoring venous return and blood circulation is vital in critical care, particularly in managing fluid therapy. Observing vena size and performance can help assess fluid status and the patient's hemodynamic stability following surgical intervention.
20) Sign:
Sign in medical terminology refers to any objective evidence of a disease or condition observed during an examination. In this study, signs may include measurable changes in electrolyte levels or vital signs post-intervention. Sign observations are crucial for evaluating patient responses to fluid therapy and guiding treatment adjustments.
21) Coma:
Coma is a state of prolonged unconsciousness where a patient cannot be awakened, presenting significant challenges in medical care. In studies involving traumatic brain injuries, understanding coma levels is vital for treatment decisions. Monitoring and managing fluid balance can play a critical role in the recovery trajectory for such patients.
22) Male:
Male refers to one gender in a population, and understanding gender demographics is essential in medical research. In this study, analyzing outcomes based on gender can uncover potential differences in response to treatments. Recognizing male patient characteristics informs tailored approaches in managing trauma and fluid therapy effectively.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Fluid Comparison in Post-op Severe TBI: Acid-Base and Electrolytes’. Further sources in the context of Science might help you critically compare this page with similair documents:
Saline Group, Statistical analysis, Patient's condition, Significant difference, Sample size, Pilot study, Electrolyte imbalance, Serum calcium, Demographic Data, Sodium Content, Renal transplantation, Hypocalcaemia, Surgical patients, Sodium level, Potassium level, Normal saline, Renal function test, Inferior vena cava, Mean Arterial Pressure, Mean Difference, Metabolic Acidosis, PH level, Renal impairment, Hypokalemia, Calcium level, Magnesium level, Potassium content, Electrolyte levels, Serum sodium concentration, Serum sodium, Serum potassium, Calcium Concentration, Magnesium Concentration, Traumatic brain injury, Packed red blood cell, Serum chloride, Serum bicarbonate, Hypomagnesemia, Chloride concentration, Sodium concentration, Intravenous infusion, Fluid therapy, Acid base balance, Serum Magnesium, Chloride Level, PH concentration, Acetate buffer, Electrolyte content, Hypernatremia, Arterial blood gas, Serum Lactate, Repeated-measures ANOVA, Lactate level, Bicarbonate level, Blood products.