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Exp Clin Transplant ; 18(1): 34-38, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30995895

RESUMO

OBJECTIVES: Normal saline is the most common crystalloid solution that is used in renal transplant surgery. In this study, our aim was to determine the effects of a combination of half saline and bicarbonate versus normal saline as a routine solution. MATERIALS AND METHODS: For this double-blind random-ized clinical trial, we enrolled 100 adult patients undergoing kidney transplant. Patients were divided into 2 groups: those who received normal saline and those who received half saline and bicarbonate infusion as fluid replacement therapy during renal transplant. All patients received about 40 mL/kg of crystalloids during surgery. Serial creatinine con-centrations (primary outcomes) were compared between groups at 1, 2, 3, and 7 days after surgery. Urine output (secondary outcome) was compared between groups at recovery and at 6 and 24 hours after surgery. In addition, base excess, chloride, and sodium levels were measured before and 6 hours after surgery. Each liter of half saline-bircarbonate, which is relatively isoosmotic to human plasma, was composed of 70 mEq bicarbonate, 77 mEq chloride, and 147 mEq sodium. RESULTS: Patients who received half saline-bicarbonate had significantly lower postoperative creatinine levels at all time points than patients who received normal saline (P = .019). Serum chloride and sodium levels (P = .001) were significantly higher and base excess (P = .007) was significantly lower in the normal saline group at 6 hours after transplant. At all time points, urine output levels were significantly higher in the half saline-bicarbonate group (P = .001). CONCLUSIONS: The use of half saline-bicarbonate was associated with better early graft function compared with normal saline in the first 7 days after transplant.


Assuntos
Acidose/prevenção & controle , Bicarbonatos/administração & dosagem , Hidratação , Cuidados Intraoperatórios , Transplante de Rim , Solução Salina/administração & dosagem , Equilíbrio Ácido-Base , Acidose/diagnóstico , Acidose/etiologia , Acidose/fisiopatologia , Adulto , Bicarbonatos/efeitos adversos , Biomarcadores/sangue , Creatinina/sangue , Método Duplo-Cego , Feminino , Hidratação/efeitos adversos , Humanos , Cuidados Intraoperatórios/efeitos adversos , Irã (Geográfico) , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Solução Salina/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
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