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Crystalloid solutions modify acid-base equilibrium according to their electrolyte composition. Moreover, it has been suggested that these alterations are generated by the difference between the solution strong ion difference (SID) and the plasma bicarbonate level. An increased risk of acute kidney injury and renal replacement therapy has been associated to the infusion of chloride rich crystalloids. This study aims to compare, in patients with acute respiratory failure undergoing ECMO support, the effects on acid-base status and renal function of crystalloids commonly employed for circuit priming to a balanced solution created with a SID equal to patients' bicarbonate level.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 0.9% NaCl | Active Comparator | Circuit priming will be performed with 0.9% NaCl solution |
|
| Ringer Lactate | Active Comparator | Circuit priming will be performed with Ringer Lactated |
|
| Balanced Solution | Experimental | Circuit priming will be performed with a Balanced Solution created by mixing 0.9% NaCl, Sodium bicarbonate (8.4%) and injectable sterile water, in order to obtain a solution with constant sodium concentration (140 mEq/l) and SID equal to patient's bicarbonate level. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Priming of ECMO circuit with 0.9% NaCl | Other | 0.9% NaCl as priming crystalloid solution |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Variation in Acid-Base Equilibrium (Base Excess) | First 24 hours after ECMO start |
| Measure | Description | Time Frame |
|---|---|---|
| Variation in Acid-Base Equilibrium (pH) | First 24 hours after ECMO start | |
| Variation in Renal Function | First 24 hours after ECMO start |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Pietro Caironi, MD | Contact | +39-02-55033232 | pietro.caironi@unimi.it |
| Name | Affiliation | Role |
|---|---|---|
| Pietro Caironi, MD | Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico | Recruiting | Milan | 20122 | Italy |
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| Priming of ECMO circuit with Ringer Lactate |
| Other |
Ringer Lactate as priming crystalloid solution |
|
| Priming of ECMO circuit with Balanced Solution | Other | Balanced Solution as priming crystalloid solution |
|
| ID | Term |
|---|---|
| D000077325 | Ringer's Lactate |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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