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Revista Medica Herediana

Print version ISSN 1018-130XOn-line version ISSN 1729-214X

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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