Abstract

MALAGA RODRIGUEZ, Germán Javier; DE PINO VELASCO, Dino Mario  and  CIEZA ZEVALLOS, Javier. 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. Rev Med Hered [online]. 2006, vol.17, n.4, pp.189-195. ISSN 1018-130X.

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).

Keywords : Fluid therapy; electrolyte disorders; acid-base disorders; Hartmann's solution; elderly; hospitalized patients.

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