Exploring The Efficacy Of Sodium Bicarbonate Ringer Injection In Patients With Hypovolemic Shock

Objective This project proposes a new extracellular fluid supplement and alkalinising agent,Bicarbonated Ringer’s solution(BRS),and investigates the clinical efficacy of BRS and the traditional resuscitation fluid,Ringer’s solution(RS),in patients with hypovolemic shock.-The clinical efficacy of Ringer’s solution(RS)in patients with hypovolemic shock is discussed to provide a new option and method of fluid resuscitation for patients in shock.Method Seventy-four patients with hypovolemic shock who attended the affiliated hospital of Qinghai University from November 2020 to November 2021 were selected for the study and were randomly assigned to the test group(n = 33)and the control group(n = 41)upon admission.The test group was given sodium bicarbonate Ringer’s solution for fluid therapy and the control group was given Ringer’s solution(compound sodium chloride injection)for fluid therapy.Arterial blood gas analysis was performed before(T0),2 hours(T2),4 hours(T4),12 hours(T12),24 hours(T24)and 48 hours(T48)after fluid treatment,and the p H,blood lactic acid(Lactic Acid,LAC),base excess(BE),bicarbonate(HCO3-),Mg2+,Clelectrolytes,safety indicators(drug-related adverse events: incidence of electrolyte disturbances,incidence of abnormal base residuals,incidence of abnormal bicarbonate,etc.),prognostic indicators(regression,incidence of multi-organ dysfunction syndrome,28-day mortality,number of days in hospital).To explore the clinical efficacy of sodium bicarbonate Ringer solution and provide new ideas for fluid resuscitation in patients in shock.Result 1.In this study,a total of 74 cases were collected,33 in the Ringer carbonate group and 41 in the Ringer group.The general data of the two groups at the time of admission were gender,age,Body Mass Index(BMI),body temperature,heart rate,respiration,arterial oxygen saturation,systolic pressure(SBP),mean arterial pressure(MAP),hemoglobin,red blood cell count,injury severity score,and major disease type.arterial pressure(MAP),haemoglobin,red blood cell count,injury severity score,and major disease type were statistically analysed,and the differences were not statistically significant(P > 0.05);the differences in blood lactate,p H,BE,HCO3-,Mg2+,and Cl-before fluid therapy(T0)between the two groups were not statistically significant(P > 0.05);the above The results can indicate that the two groups of patients remained balanced at the time of admission,i.e.before resuscitation,at baseline,i.e.the two groups were comparable and could be analysed for follow-up.2.The two groups were followed up for LAC,p H,BE,HCO3-,Mg2+ and Cl-comparisons.(1)Comparison between groups: In both groups LAC,Cl-liquid treatment T2,T4,T12,T24 and T48,the carbonic acid Ringer group was lower than the Ringer group at the same time point,the difference was statistically significant(P < 0.05).In both groups,p H,BE,HCO3-and Mg2+fluids were higher in the carbonated Ringer group than in the Ringer group at the same time point when treating T2,T4,T12,T24 and T48,and the difference was statistically significant(P < 0.05).(2)Intra-group comparison: LAC was lower than T0 at T48 in the two groups of patients treated with liquids,the difference was statistically significant(P < 0.05),p H,BE and HCO3-were higher than T0 at T48,the difference was statistically significant(P < 0.05);T24 Cl-level was lower than T0 in the carbonated Ringer group and T24 Cl-level was higher than T0 in the Ringer group,the difference was statistically significant(P <0.05);the Mg2+ level at T48 in the Ringer carbonate group was higher than T0,and the Mg2+ level at T48 in the Ringer group was lower than T0,and the difference was statistically significant(P <0.05).3.The patients’ drug-related adverse events were collected: a total of 14 cases of drug-related adverse reactions occurred in the Ringer carbonate group,including 5 cases of elevated PH value,3 cases of elevated BE value and 6cases of elevated HCO3-value;a total of 9 cases of drug-related adverse reactions occurred in the Ringer group,including 5 cases of elevated PH value,3 cases of elevated BE value and 1 case of elevated HCO3-value;the differences in the three drug-related adverse reactions between the two groups were not statistically significant(P > 0.05).The differences between the two groups were not statistically significant(P>0.05).4.The prognostic indicators of the patients were collected:regression,occurrence of multi-organ dysfunction syndrome,28-day mortality rate,and number of days in hospital for statistical analysis;the differences in regression,incidence of multi-organ dysfunction syndrome,and 28-day mortality rate were not statistically significant(P>0.05);the number of days in hospital was lower in the Ringer group than in the Ringer group,and the differences were statistically significant(P < 0.05).Conclusion 1.Patients in hypovolemic shock commonly show signs of metabolic acidosis with excessive lactate accumulation and lower than normal PH,BE and HCO3-values.2.Compared with traditional crystalloids,sodium bicarbonate Ringer fluid can correct acidosis and achieve acid-base balance more quickly and significantly.It also has significant advantages in restoring tissue perfusion and maintaining electrolyte balance.