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High Strong Ion Difference Fluid vs Hartmann's Solution on Acid-Base Status in Sepsis

Not Applicable
Completed
Conditions
Septicemic Shock
Registration Number
NCT03530046
Lead Sponsor
Clinical Research Centre, Malaysia
Brief Summary

This is a research to study primarily the effect of rapidly infused high strong ion difference (SID) fluid vs Hartmann's solution in altering the pH and bicarbonate level of the patient, who is in sepsis with metabolic acidosis. Half of the study population gets high SID fluid, while the other half will get Hartmann's solution.

Detailed Description

Balanced fluids are preferred in initial resuscitation of septic patients based on several recent studies.

The Stewart's concept on acid-base balance predicts that high strong ion difference (SID) fluid thus will increase the pH level.

High SID fluid are specially formulated by adding sodium bicarbonate into half saline solution, the resultant fluid contains sodium= 145mmol/L and chloride=70mmol/L (SID= 75) as compared to Hartmann's solution with the SID of 20.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
162
Inclusion Criteria
  • age≥18 years
  • fulfills 2/3 qSOFA criteria
  • presumed infection
  • a blood pH at presentation ≤ 7.35
  • hyperlactatemia (blood lactate level, >2mmol/L )
Exclusion Criteria
  • existing cardiac failure, major cardiac arrhythmia, advanced chronic kidney disease or end stage failure
  • known pregnancy
  • suspected dengue
  • primary diagnosis is related to burn, trauma, or drug overdose
  • if more than 500cc of resuscitation fluid was administered before enrollment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
bicarbonate level change2 hours

mmol/L

pH change2 hours
Secondary Outcome Measures
NameTimeMethod
Lactate level difference2 hours

percentage

Development of pulmonary edema48 hours
Length of stay90 days
30 days all-cause mortality30 days

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