Effect of Bicarbonated Ringer's solution on acid-base status in hemorrhagic shock

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  • 重炭酸リンゲル液のアシドーシス補正効果―イヌの出血性ショックモデルにおいて―

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The effects of bicarbonated Ringer's solution containing 1 mEq/L of magnesium (BR), acetated Ringers solution (AR), lactated Ringer's solution (LR) or Ringer's solution (NR) for correcting metabolic acidosis were studied in a model of hemorrhagic shock (n=20) . Shock was produced for the mean arterial pressure to reach 40mmHg in dogs by hemorrhage via external jugular vein at a speed of 1 ml/kg/min. At the time when base excess reached-13mEq/L, the fluids were infused at a rate of 1 ml/kg/min over a 90min period. Arterial blood gas values, blood metabolic variables, plasma electrolytes were measured before, during and after the infusion. Bicarbonate, pH and base excess (BE) in BR returned to the control values with rapidity, compared with those received AR, LR or NR. The maximum effect on correcting metabolic acidosis in AR and LR occurred after infusion of fluids were completed, showing that acetate and lactate need some time to be metabolized. On the basis of the finding of this study, bicarbonate is a buffer which is more effective on correcting metabolic acidosis than acetate and lactate in hemorrhagic shock.

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