• I Aramendi, A Stolovas, S Mendaña, A Barindelli, W Manzanares, and A Biestro.
• Cátedra de Medicina Intensiva, Centro de Tratamiento Intensivo, Hospital de Clínicas Dr. Manuel Quintela, Facultad de Medicina, Universidad de la República (UdelaR), Montevideo, Uruguay. Electronic address: nachoaramendi@gmail.com.
• Med Intensiva. 2021 Oct 1; 45 (7): 421-430.

ObjectiveTo evaluate the impact of the infusion of sodium lactate 500ml upon different biochemical variables and intracranial pressure in patients admitted to the intensive care unit.DesignA prospective experimental single cohort study was carried out.ScopePolyvalent intensive care unit of a university hospital.PatientsCritical patients with shock and intracranial hypertension.ProcedureA 500ml sodium lactate bolus was infused in 15min. Plasma levels of sodium, potassium, magnesium, calcium, chloride, lactate, bicarbonate, PaCO2, pH, phosphate and albumin were recorded at 3timepoints: T0 pre-infusion; T1 at 30minutes, and T2 at 60minutes post-infusion. Mean arterial pressure and intracranial pressure were measured at T0 and T2.ResultsForty-one patients received sodium lactate: 19 as an osmotically active agent and 22 as a volume expander. Metabolic alkalosis was observed: T0 vs. T1 (P=0.007); T1 vs. T2 (P=0.003). Sodium increased at the 3time points (T0 vs. T1, P<0.0001; T1 vs. T2, P=0.0001). In addition, sodium lactate decreased intracranial pressure (T0: 24.83±5.4 vs. T2: 15.06±5.8; P<0.001). Likewise, plasma lactate showed a biphasic effect, with a rapid decrease at T2 (P<0.0001), including in those with previous hyperlactatemia (P=0.002).ConclusionsThe infusion of sodium lactate is associated to metabolic alkalosis, hypernatremia, reduced chloremia, and a biphasic change in plasma lactate levels. Moreover, a decrease in intracranial pressure was observed in patients with acute brain injury.Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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