| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website https://www.jocmr.org |
Original Article
Volume 16, Number 1, January 2024, pages 1-7
Use of a Novel Buffered Hypertonic Saline Solution for Fluid Replacement and Resuscitation During Spinal Surgery in Adolescents
Tables
| Variables | Hypertonic saline (n = 23) | Control group (n = 25) | Entire cohort (n = 48) |
|---|---|---|---|
| Data are listed as the mean ± SD (range) or number (%). There were no statistically significant differences among the groups. SD: standard deviation. | |||
| Age (years) | 15.4 ± 1.9 (11.5 - 19.0) | 14.9 ± 1.9 (12.4 - 19.7) | 15.1 ± 1.9 (11.5 - 19.6) |
| Gender (female/male) | 17/6 | 19/6 | 36/12 |
| Weight (kg) | 60.0 ± 17.3 (34.3 - 97.3) | 63.1 ± 30.8 (33.2 - 173.6) | 61.6 ± 25.0 (33.2 - 173.6) |
| Height (cm) | 160.3 ± 24.0 (58.2 - 179.3) | 155.3 ± 22.2 (57.7 - 177.5) | 157.7 ± 22.9 (57.7 - 179.3) |
| Ethnicity | |||
| Hispanic | 1 (4%) | 0 | 1 (2%) |
| Non-Hispanic | 22 (96%) | 25 (100%) | 47 (98%) |
| Race | |||
| Caucasian | 18 (78%) | 18 (72%) | 36 (75%) |
| African American | 3 (13%) | 4 (16%) | 7 (15%) |
| Asian | 1 (4%) | 1 (4%) | 2 (4%) |
| Multi-racial | 0 (0%) | 1 (4%) | 1 (2%) |
| Other | 1 (4%) | 1 (4%) | 2 (4%) |
| Variable | Hypertonic saline (n = 23) | Control (n = 25) | Entire cohort (n = 48) |
|---|---|---|---|
| Data are listed as the mean ± SD (range) or the number (%). There were no statistical differences between the two groups. SD: standard deviation. | |||
| Osteotomy performed (yes/no) | 17 (74%)/6 | 16 (64%)/9 | 33 (69%)/15 |
| Total anesthesia time (min) | 398 ± 79 (271 - 519) | 370 ± 48 (270 - 459) | 383 ± 60 (270 - 519) |
| Total surgical time (min) | 282 ± 66 (180 - 409) | 251 ± 45 (159 - 336) | 265 ± 58 (159 - 409) |
| Urine output (mL) | 619 ± 415 (110 - 1,655) | 504 ± 343 (110 - 1,500) | 559 ± 380 (110 - 1,655) |
| Estimated blood loss (mL) | 411 ± 290 (50 - 1,200.00) | 523 ± 225 (150 - 1,100) | 471 ± 261 (50 - 1,200) |
| Fluids | Hypertonic saline (n = 23) | Control (n = 25) | Entire cohort (n = 48) | P value* |
|---|---|---|---|---|
| Data are listed as the mean ± SD (range) or the number (%). *P value for hypertonic saline versus control group. aVolume of albumin administered is calculated using a denominator of 23 in the hypertonic saline cohort and 25 in the control cohort. Volumes were equivalent if the calculation is completed using only those patients that received albumin (333 ± 129 mL in the 2% buffered hypertonic saline cohort versus 487 ± 195 mL in the control cohort). bVolume of crystalloid includes all intraoperative fluids including normal saline, lactated Ringer’s, and Normosol®-R. SD: standard deviation. | ||||
| Albumin used (number and %) | 6 (26%) | 19 (76%) | 25 (52%) | 0.0005 |
| Volume of albumin (mL)a | 91 ± 164 (0 - 500) | 370 ± 271 (0 - 1,000) | - | < 0.0001 |
| Crystalloid fluids (mL)b | 1,484 ± 678 (320 - 3,113) | 1,652 ± 522 (645 - 2,535) | 1,571 ± 602 (320 - 3,113) | 0.3392 |
| 2% hypertonic saline (mL) | 646 ± 402 (233 - 2,000) | - | - | - |
| Variables | Hypertonic saline (n = 23) | Control (n = 25) | P-value* |
|---|---|---|---|
| Data are listed as the mean ± SD. *P value for hypertonic saline versus control group. SD: standard deviation. | |||
| First hemoglobin (g/dL) | 11.3 ± 2.8 | 11.6 ± 1.2 | NS |
| Last hemoglobin (g/dL) | 11.4 ± 1.4 | 9.9 ± 1.7 | 0.0042 |
| First hematocrit (%) | 35.7 ± 5.6 | 35 ± 3 | NS |
| Last hematocrit (%) | 33.2 ± 8.5 | 30 ± 5 | NS |
| First pH | 7.43 ± 0.04 | 7.41 ± 0.04 | NS |
| Last pH | 7.40 ± 0.03 | 7.36 ± 0.06 | 0.0131 |
| First PaCO2 (mm Hg) | 38 ± 4 | 38 ± 4 | NS |
| Last PaCO2 (mm Hg) | 41 ± 4 | 41 ± 6 | NS |
| First base deficit | 1.3 ± 1.2 | 1.0 ± 1.0 | NS |
| Last base deficit | 2.1 ± 4.5 | 2.6 ± 2.1 | NS |
| First sodium (mEq/L) | 141 ± 2 | 139 ± 2 | 0.0008 |
| Last sodium (mEq/L) | 143 ± 3 | 141 ± 3 | 0.0061 |