caa a22 4500 51079999X CHVBK 20180627064225.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s12028-012-9764-3 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9764-3 Randomized, Double-Blind Trial of the Effect of Fluid Composition on Electrolyte, Acid-Base, and Fluid Homeostasis in Patients Early After Subarachnoid Hemorrhage [Elektronische Daten] [Laura Lehmann, Stepani Bendel, Dominik Uehlinger, Jukka Takala, Margaret Schafer, Michael Reinert, Stephan Jakob] Background: Hyper- and hyponatremia are frequently observed in patients after subarachnoidal hemorrhage, and are potentially related to worse outcome. We hypothesized that the fluid regimen in these patients is associated with distinct changes in serum electrolytes, acid-base disturbances, and fluid balance. Methods: Thirty-six consecutive patients with SAH were randomized double-blinded to either normal saline and hydroxyethyl starch dissolved in normal saline (Voluven®; saline) or balanced crystalloid and colloid solutions (Ringerfundin® and Tetraspan®; balanced, n=18, each) for 48h. Laboratory samples and fluid balance were evaluated at baseline and at 24 and 48h. Results: Age [57±13years (mean±SD; saline) vs. 56±12years (balanced)], SAPS II (38±16 vs. 34±17), Hunt and Hess [3 (1-4) (median, range) vs. 2 (1-4)], and Fischer scores [3.5 (1-4) vs. 3.5 (1-4)] were similar. Serum sodium, chloride, and osmolality increased in saline only (p≤0.010, time-group interaction). More patients in saline had Cl >108mmol/L [16 (89%) vs. 8 (44%); p=0.006], serum osmolality >300mosmol/L [10 (56%) vs. 2 (11%); p=0.012], a base excess <−2 [12 (67%) vs. 2 (11%); p=0.001], and fluid balance >1,500mL during the first 24h [11 (61%) vs. 5 (28%); p=0.046]. Hyponatremia and hypo-osmolality were not more frequent in the balanced group. Conclusions: Treatment with saline-based fluids resulted in a greater number of patients with hyperchloremia, hyperosmolality, and positive fluid balance >1,500mL early after SAH, while administration of balanced solutions did not cause more frequent hyponatremia or hypo-osmolality. These results should be confirmed in larger studies. Springer Science+Business Media, LLC, 2012 Subarachnoid hemorrhage nationallicence Fluid therapy nationallicence Osmolality nationallicence Acid-base balance nationallicence Lehmann Laura Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Bendel Stepani Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Uehlinger Dominik Department of Nephrology and Hypertension, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Takala Jukka Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Schafer Margaret Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Reinert Michael Department of Neurosurgery, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Jakob Stephan Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut Neurocritical Care Humana Press Inc 18/1(2013-02-01), 5-12 1541-6933 18:1<5 2013 18 12028 https://doi.org/10.1007/s12028-012-9764-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9764-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lehmann Laura Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Bendel Stepani Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Uehlinger Dominik Department of Nephrology and Hypertension, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Takala Jukka Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Schafer Margaret Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Reinert Michael Department of Neurosurgery, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 700 1- Jakob Stephan Department of Intensive Care Medicine, Bern University Hospital (Inselspital) and University of Bern, 3010, Bern, Switzerland aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/1(2013-02-01), 5-12 1541-6933 18:1<5 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence SWISSBIB 51079999X BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer