Evaluation of Plasma-Lyte and 0.9% sodium chloride administration in hydroelectrolytic, acid-base and renal function in patients submitted to neurosurgery: randomized clinical trial

• Grant number: 18/15512-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2018
• End date: May 31, 2020
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Norma Sueli Pinheiro Módolo
• Grantee: Vitória Mariah Giriboni
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

In neurosurgery the administration of fluids in the perioperative aims to preservation of cerebral perfusion pressure, avoiding hyperglycemia and acid-base and hydroelectrolytic balance. The liquid administered may interfere with the acid-base balance, hydroelectrolytic and renal function. Administration of 0.9% saline solution may hyperchloremic metabolic acidosis, with a reduction in the concentration ofbicarbonate and increase the base deficit. However, it is the used in neurosurgery.Plasma-Lyte 148 is a more balanced saline solution, which has a plasma-like constitution. What limits its administration is the very higher than the 0.9% SF. The SF 0.9% is already the most used intraoperative fluid inneurosurgery, which is considered to have the least influence on the formation of free consequently lower. Objective: to evaluate which of the two solutions used causes less alteration in the balance acid-base, hydroelectrolytic, renal function and hemodynamic stability and facilitates the hospital. Methodology: a randomized clinical trial will be performed in patients submitted to neurosurgery (aneurysm clipping and tumors) allocated in two study groups, differentiated by the fluid used for volume replacement, intraoperatively (GroupSF 0.9% and Plasma-Lyte Group 148). The following parameters will be evaluated: - Acid-base balance (pH, bicarbonate, BE)- Hydroelectrolytic balance (sodium, calcium, potassium, chlorine, plasma magnesium) - Renal function (creatinine)- Stability Hemodynamics (mean arterial pressure, heart rate, PETCO2, SatHb)- Intraoperative bleeding- Brain relaxation (surgeon impression).- Extubation time- Time spent in the ICU- Length of hospital stay.