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| Name | Class |
|---|---|
| Cristina Dominedò | UNKNOWN |
| Marco Rossi | UNKNOWN |
| Rossano Festa | UNKNOWN |
| Nicoletta Filetici |
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The present study will investigate variations in acid base equilibrium caused by the administration of four different crystalloids with increasing strong ion difference (0.9% saline, Ringer's lactate, Ringer's acetate, plasmalyte-like solution) in patients during general anesthesia.
The same crystalloid will be administered throughout the surgery. In order to assess the effect of hemodilution, every patient will receive two fluid boli with different volumes of the same solution. pH and strong ion variations, togher with the renal response to acid base disturbances, will be analysed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Chloride-rich solution | Experimental | Patients will receive two boluses of 10 and 20 ml/kg of the 0.9% saline in two different moments after at least 1 hour from each other. Plasma arterial blood gas (ABG) and electrolytes, along with plasmatic creatinine, albumin and phosphate will be measured immediately before and five minutes after fluid boluses. Urinary electrolytes (Na, K, Cl) will be measured immediately before fluid bolus and after one hour from fluid administration along with ABG and plasmatic electrolytes and creatinine, phosphate and albumin. |
|
| Low-chloride solution A | Experimental | Patients will receive two boluses of 10 and 20 ml/kg of Ringer's lactate in two different moments after at least 1 hour from each other. Plasma arterial blood gas (ABG) and electrolytes, along with plasmatic creatinine, albumin and phosphate will be measured immediately before and five minutes after fluid boluses. Urinary electrolytes (Na, K, Cl) will be measured immediately before fluid bolus and after one hour from fluid administration along with ABG and plasmatic electrolytes and creatinine, phosphate and albumin. |
|
| Very low-chloride solution | Experimental | Patients will receive two boluses of 10 and 20 ml/kg of a plasmalyte-like solution (namely soluzione elettrolitica reintegrante [SER]) in two different moments after at least 1 hour from each other. Plasma arterial blood gas (ABG) and electrolytes, along with plasmatic creatinine, albumin and phosphate will be measured immediately before and five minutes after fluid boluses. Urinary electrolytes (Na, K, Cl) will be measured immediately before fluid bolus and after one hour from fluid administration along with ABG and plasmatic electrolytes and creatinine, phosphate and albumin. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 0.9% saline administration | Other | Each patient will receive 0.9%saline based on attending physician decision |
|
| Measure | Description | Time Frame |
|---|---|---|
| pH modification | The primary outcome of this physiological study is to evaluate, in vivo, the effect of crystalloid administration with different SID on acid base equilibrium, in particular pH variations will be considered. | Surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Urinary SID modification (mEq/L) after crystalloids administration with different SID and chloride load | renal response to acid base disturbances caused by different crystalloid infusions and different volumes. | Surgery |
| SID and plasmatic weak acid (A tot) variations measured in mEq/L |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Antonio M Dell'Anna, MD | Fondazione Policlinico A. Gemelli | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fondazione Policlinico A. Gemelli | Roma | 00168 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40263186 | Derived | Dell'Anna AM, Grieco DL, Dominedo C, Cicetti M, Cisterna I, Festa R, Lamacchia R, Gianni G, Filetici N, Michi T, Rossi C, Alcaro FD, Mele A, Rocchi A, Del Prete D, Meluzio MC, Tamburrelli FC, Rossi M, Antonelli M. Stewart's theory and acid-base changes induced by crystalloid infusion in humans: a randomized physiological trial. Ann Intensive Care. 2025 Apr 22;15(1):54. doi: 10.1186/s13613-025-01473-9. |
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| Marta Cicetti | UNKNOWN |
| Domenico Luca Grieco | UNKNOWN |
| Massimo Antonelli | UNKNOWN |
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| Ringer's lactate administration | Other | Each patient will receive Ringer's lactate based on attending physician decision |
|
| Plasmalyte-like solution administration | Other | Each patient will receive Plasmalyte-like solution based on attending physician decision |
|
We will explore the changes in apparent SID (SIDapp) and effective SID (SIDeff) and strong ion gap (SIG), as well as A tot after administration of solutions with different SID |
| Surgery |
| ID | Term |
|---|---|
| D013398 | Sudden Infant Death |
| D000137 | Acid-Base Imbalance |
| ID | Term |
|---|---|
| D003645 | Death, Sudden |
| D003643 | Death |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D066088 | Infant Death |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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