• Arch Surg Chicago · Oct 1990

    Randomized Controlled Trial Comparative Study Clinical Trial

    Analysis of potential risks associated with 7.5% sodium chloride resuscitation of traumatic shock.

    • M J Vassar, C A Perry, and J W Holcroft.
    • Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.
    • Arch Surg Chicago. 1990 Oct 1;125(10):1309-15.

    AbstractWe evaluated the potential side effects of rapidly infusing 250 mL of either 7.5% sodium chloride or 7.5% sodium chloride per 6% dextran 70, using lactated Ringer's as the control, to 106 critically injured patients in two prospective double-blinded emergency department trials. Eight patients had a significant hyperchloremic acidemia in association with infusion of the hypertonic solutions, but all eight were moribund before infusion and many factors other than hyperchloremia could have contributed to their acidemia. Other blood chemistry changes that might have been associated with the hypertonic solutions, such as hyperosmolality or hypernatremia, were made insignificant by other factors, such as high blood alcohol levels or concomitant administration of sodium bicarbonate. There were no cases of central pontine myelinolysis; bleeding was not potentiated. There was no difficulty with crossmatching of blood. No anaphylactoid reactions occurred. In a setting of limited volume resuscitation, the solutions are likely to have a favorable risk-to-benefit ratio.

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