Effect Of Sodium Bicarbonated Ringer’s Solution On Early Fluid Resuscitation In Traumatic Hemorrhagic Shock

Objective: To investigate the effect of Sodium bicarbonated Ringer’s solution limited fluid resuscitation on acidosis,inflammatory factor expression and coagulation function in patients with traumatic hemorrhagic shock,in order to provide theoretical reference for screening the ideal resuscitation fluid for the treatment of patients with traumatic hemorrhagic shockMethods: Patients with traumatic hemorrhagic shock admitted to the emergency surgery department of The Second Affiliated Hospital of Anhui Medical University from October 2020 to October 2021 were selected for a prospective randomized controlled study.A total of 68 patients with traumatic hemorrhagic shock were included,including 44 males and 24 females,aged 19-67 years old,with an average age of 48.60 years old.Traffic accident ranked first among the causes of injury,followed by fall injury.All patients were randomized to sodium lactate Ringer’s solution resuscitation group（LRS group,n=33）or sodium bicarbonate Ringer solution resuscitation group（BRS group,n=35）.sodium lactate Ringer’s solution and sodium bicarbonate Ringer’s solution were used for restricted fluid resuscitation.Arterial blood and peripheral venous blood were collected before and 1 hour after resuscitation,respectively,and the arterial lactic acid value and PH,the levels of IL-6 and TNF-α in peripheral venous blood,and the indexes of coagulation function of peripheral venous blood（R value,K value and MA value）were detected by corresponding methods before and after resuscitation..The resuscitation effect of sodium bicarbonate Ringer’s solution on traumatic hemorrhagic shock was evaluated by comparing the indexes of the two groups before and after resuscitation.Results: Before resuscitation,there was no significant difference in the above indexes between the two groups（P>0.05）.1 hour after resuscitation,lactic acid value decreased and PH value improved in both groups,and the change was more obvious in the resuscitation group with sodium bicarbonate Ringer solution,the difference was statistically significant（P<0.05）,indicating that sodium bicarbonate Ringer’s solution can significantly improve the degree of acidosis in patients with traumatic hemorrhagic shock.1 hour after resuscitation,il-6 and TNF-α were increased in both groups,but the increase was smaller in the ringer solution resuscitation group,and the difference was statistically significant（P<0.05）,indicating that sodium bicarbonate Ringer’s solution can significantly inhibit the expression of inflammatory factors in patients with traumatic hemorrhagic shock.1 hour after resuscitation,R value and K value were prolonged in both groups,but the change of sodium bicarbonate Ringer solution resuscitation group was small,and the difference was statistically significant（P<0.05）;One hour after resuscitation,MA value in the ringer solution resuscitation group was further reduced,while MA value in the ringer solution resuscitation group was improved,and the difference was statistically significant（P<0.05）,indicating that sodium bicarbonate Ringer’s solution has little effect on coagulation function in patients with traumatic hemorrhagic shock.Conclusion: Compared with sodium lactate Ringer’s solution,sodium bicarbonate Ringer’s solution can significantly improve the acidosis of patients with traumatic hemorrhagic shock,inhibit the expression of inflammatory factors,and have less effect on coagulation function...