Comparison of the effect of combination of normal saline & half normal saline versus normal saline & lactate based balanced salt solution on acid base status and electrolyte homeostasis intraoperatively and on early graft function postoperatively in kidney transplantation

This study aimed to quantify changes in acid-base balance, different electrolytes (sodium, potassium, chloride & bicarbonate) following administration of different combinations of intravenous fluids during renal transplantation and to study their effect on early graft function postoperatively.

In this double blind study, patients were randomized into two groups( n1=35,n2=39) to receive either combination of normal saline & half normal saline or combination of normal saline & ringer lactate during renal transplantation. Arterial blood gas analysis were performed before induction of anesthesia, during vascular anastomosis, one hour after bladder clamp release and after extubation. Blood urea and serum creatinine were measured before induction of anesthesia, immediately after surgery, one hour after extubation, on first postoperative day and on second postoperative day. Urine output was recorded at one hour after bladder clamp release, one hour after extubation and on first & second postoperative days.

There was a statistically significant increase in the highest serum potassium level, highest chloride level and increase in the serum chloride measured at the end of study in patients who received combination of NS & half NS. Statistically significant increase in blood urea & serum creatinine was seen immediate postoperatively in patients who received combination of NS & Half NS. No significant changes in pH, Bicarbonate, S. sodium, lactate & urine output were seen with both the fluid combinations in either group.

We concluded that a combination of NS & RL is equally safe or even superior compared to combination of NS & Half NS in renal transplantation.


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