Evidence map›Paper›PMID 32995241›Full record

ArticleJournal of acute medicine2019

A Double-Blind, Randomized Control Trial of Rapidly Infused High Strong Ion Difference (SID) Fluid Versus Hartmann's Solution on Acid-Base Status in Sepsis Patients in the Emergency Department.

Chunchiat Yeoh, Aikhowe Teo, Abdul Muhaimin Noor Azhar, Sherene Tan Suann, Yingying Thum, Kwanhathai Darin Wong, Huahchiang Ooi, Sasi Kumar A/L Sappanie, Aidawati Bustam, Rashidi Ahmad

Open access · greenAbstract read
In one paragraph

Article in Journal of acute medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Chunchiat YeohHospital Pulau Pinang Emergency Department Pulau Pinang Malaysia.
Aikhowe TeoHospital Pulau Pinang Emergency Department Pulau Pinang Malaysia.
Abdul Muhaimin Noor AzharUniversity of Malaya Emergency Department Wilayah Persekutuan Kuala Lumpur Malaysia.
Sherene Tan SuannHospital Pulau Pinang Pharmacy Department Pulau Pinang Malaysia.
Yingying ThumHospital Pulau Pinang Emergency Department Pulau Pinang Malaysia.
Kwanhathai Darin WongHospital Pulau Pinang Emergency Department Pulau Pinang Malaysia.
Huahchiang OoiHospital Pulau Pinang Emergency Department Pulau Pinang Malaysia.
Sasi Kumar A/L SappanieHospital Pulau Pinang Emergency Department Pulau Pinang Malaysia.
Aidawati BustamUniversity of Malaya Emergency Department Wilayah Persekutuan Kuala Lumpur Malaysia.
Rashidi AhmadUniversity of Malaya Emergency Department Wilayah Persekutuan Kuala Lumpur Malaysia.
Hospital Pulau Pinang · MYUniversity of Malaya · MY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBalanced fluids are preferred in initial resuscitation of septic patients based on several recent studies. The Stewart's concept on acid-base balance predicts that high strong ion difference (SID) fluid thus will increase the pH level. To date, the impact of high SID fluid in septic patient with metabolic acidosis remains uncertain. We conducted single center, randomized, double-blind trial to compare the effect of high SID fluid vs. Hartmann's solution on acid-base status in selected sepsis patients in the Emergency Department.

methodsSeptic patient with hyperlactatemia and metabolic acidosis were randomized to receive either high SID fl uid or Hartmann's solution during initial fl uid resuscitation. The primary outcome measures the pH and bicarbonate levels difference pre- and post- resuscitation.

resultsOne hundred and sixty-two patients underwent randomization, 81 were assigned each to receive high SID fluid or Hartmann's solution. Both groups had similar baseline characteristics. High SID group received 23.5 mL/kg and the Hartmann's group received 22.7 mL/kg (p = 0.360). High SID fluid increased the mean (± SD) pH by 0.107 (± 0.09) vs. Hartmann's solution by 0.014 (± 0.12), p ≤ 0.001. Mean bicarbonate level increased signifi cantly in high SID group compared to Hartmann's (4.30 ± 3.76 vs. 1.25 ± 3.33, p ≤ 0.001). High SID group had higher post resuscitation lactate clearance than Hartmann's group (25.4 ± 28.3% vs. 12.0 ± 34.1%, p = 0.009). Shorter hospital stay was observed in highSID group 8.04 ± 5.96 days vs. Hartmann's group 12.18 ± 12.41 days (p = 0.048). Both groups showed no difference in incidence of pulmonary oedema, acute kidney injury and mortality.

conclusionsInitial resuscitation using high SID fluid in selected septic patient improves pH and bicarbonate levels. The high SID group had better post resuscitation lactate clearance and shorter hospital stay.

Indexed as

balanced fluidHartmann’s solutionhigh strong ion differenceresuscitationsepsis

Identifiers

PMID32995241
PMCPMC7440369
OpenAlexW2988070877

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.