Effects of Intravenous Fluid Therapy on Clinical and Biochemical Parameters of Trauma Patients

Shahram Paydar--- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Hamid Bazrafkan--- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Nasim Golestani--- Emergency Medicine Department, Isfahan University of Medical Sciences, Isfahan, Iran,
Jamshid Roozbeh--- Nephrology ward, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,
Abbas Akrami--- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Ali Mohammad Moradi--- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract


245

Introduction: The administration of crystalloid fluids is considered as the first line treatment in management of trauma patients. Infusion of intravenous fluids leads to various changes in hemodynamic, metabolic and coagulation profiles of these patients. The present study attempted to survey some of these changes in patients with mild severity trauma following normal saline infusion. Methods: This study comprised 84 trauma patients with injury of mild severity in Shahid Rajaei Hospital, Shiraz, Iran, during 2010-2011. The coagulation and metabolic values of each patient were measured before and one and six hours after infusion of one liter normal saline. Then, the values of mentioned parameters on one and six hours after infusion were compared with baseline measures using repeated measures analysis of variance. Results: Eighty four patients included in the present study (76% male). Hemoglobin (Hb) (df: 2; F=32.7; p<0.001), hematocrit (Hct) (df: 2; F=30.7; p<0.001), white blood cells (WBC) (df: 2; F=10.6; p<0.001), and platelet count (df: 2; F=4.5; p=0.01) showed the decreasing pattern following infusion of one liter of normal saline. Coagulation markers were not affected during the time of study (p>0.05). The values of blood urea nitrogen (BUN) showed statistically significant decreasing pattern (df: 2; F=5.6; p=0.007). Pressure of carbon dioxide (PCO2) (df: 2; F=6.4; p=0.002), bicarbonate (HCO3) (df: 2; F=7.0; p=0.001), and base excess (BE) (df: 2; F=3.3; p=0.04) values showed a significant deteriorating changes following hydration therapy. Conclusion: It seems that, the infusion of one liter normal saline during one hour will cause a statistically significant decrease in Hb, Hct, WBC, platelet, BUN, BE, HCO3, and PCO2 in trauma patients with mild severity of injury and stable condition. The changes in, coagulation profiles, pH, PvO2, and electrolytes were not statistically remarkable.

 


Keywords


Fluid Therapy; blood gas analysis; hemodilution; multiple trauma

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DOI: http://dx.doi.org/10.22037/emergency.v2i2.5908

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