Ringer's lactate administered at 15 °C leads to a greater and more prolonged increase in blood pressure compared to 37 °C.

Autor: Biesenbach P; Research Unit in Emergency Medicine, University Hospital of Southern Denmark Esbjerg, Finsensgade 35, 6700, Esbjerg, Region of Southern Denmark, Denmark. peter.biesenbach@rsyd.dk., Mølmer MB; Department of Emergency Medicine, University Hospital Odense, Odense, Denmark., Svendsen EL; Department of Emergency Medicine, University Hospital Odense, Odense, Denmark., Teichmann D; SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark., Wuthe S; Department of Applied Natural Sciences, Luebeck University of Applied Sciences, Lübeck, Germany., Momeni M; SDU Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark., Kristensen MR; Research Unit in Emergency Medicine, University Hospital of Southern Denmark Esbjerg, Finsensgade 35, 6700, Esbjerg, Region of Southern Denmark, Denmark., Laugesen LE; Research Unit in Emergency Medicine, University Hospital of Southern Denmark Esbjerg, Finsensgade 35, 6700, Esbjerg, Region of Southern Denmark, Denmark., Berg-Beckhoff G; Department of Public Health, University of Southern Denmark, Odense, Denmark., Bentsen LP; Department of Emergency Medicine, University Hospital Odense, Odense, Denmark., Bergmann ML; Department of Biochemistry and Immunology, University Hospital of Southern Denmark Vejle, Vejle, Denmark., Brabrand M; Department of Emergency Medicine, University Hospital Odense, Odense, Denmark.; Emergency Medicine Academic Unit, Chinese University of Hong Kong, Ma Liu Shui, China.; Department of Clinical Medicine, University of Southern Denmark, Odense, Denmark.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Oct 26; Vol. 14 (1), pp. 25592. Date of Electronic Publication: 2024 Oct 26.
DOI: 10.1038/s41598-024-76858-0
Abstrakt: 18 Participants were randomized to receive 30 ml/kg bodyweight Ringer's Lactate at 37° or 15 °C over 30 min. In a second session, participants were crossed over. Over a 120 min period after starting the fluid bolus we measured mean arterial pressure (MAP), cardiac output, systemic vascular resistance, and catecholamine levels. After infusion with cold fluids, the absolute increase in MAP at 45 min was significantly higher at + 6.5 mmHg (95% CI 4.8-8.2) compared with warm fluids (+ 0.6 mmHg, 95% CI, - 1.6 to 2.8; p < 0.001). This increase in MAP was longer-lasting after cold fluids (81.7 min, 95% CI 62.5-100.9) than after warm fluids (19.2, 95% CI 3.4-35; p < 0.001). While cardiac output was similar, systemic vascular resistance increase was greater after cold fluids (159 dyn s/cm 5 , 95% CI 9.5-309) compared to warm fluids (- 66 dyn s/cm 5 , 95% CI - 191 to 57; p = 0.012). Moreover, noradrenaline increased by up to 246% during cold fluids, and decreased with warm fluids (p < 0.001). Fluid bolus given at 15 °C, compared to 37 °C, leads to a greater and more prolonged increase in MAP accompanied by release of intrinsic noradrenaline and vasoconstriction. These results suggest that fluid temperature rather than volume is predominantly responsible for any increase in MAP.Trial Registration: EudraCT-nummer 2022-002137-34 and clinicaltrials.gov NCT05610254 (first registration 09/11/2022).
(© 2024. The Author(s).)
Databáze: MEDLINE
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