Post graduate resident, Emergency Medicine department, Kamineni institute of medical sciences, Narketpally, Nalgonda, Telangana, India.

Head of the department, Emergency Medicine department Kamineni institute of medical sciences, Narketpally, Nalgonda, Telangana, India

Post graduate resident, Emergency Medicine department Kamineni institute of medical sciences, Narketpally, Nalgonda, Telangana, India.
Ringer’s Lactate ,Normal Saline ,Severe Sepsis ,Hyperchloremia ,Crystalloids ,Serum Lactate ,Base Excess Levels ,

Approximately 154mM Na+ and Cl- with average pH of 5.0 and osmolarity of 308mOsm/L is possessed by normal saline. Whereas, ringer’s lactate possess 109mM Cl-, 28mM lactate and electrolytes 130mM Na+. Normal saline is usually used in blood storage and blood transfusion. Hyperchloremia is known to cause renal problems like reduced GFR, renal vasoconstriction thereby, reduction in renal artery flow, which may be the consequences of increase chlorine levels by administering normal saline. Similarly the drawbacks of ringer’s lactate include blood clot formation which is a severe threat in therapeutic management. A total of 56 patients have been enrolled into the study, and have been divided randomly into 2 groups based on the type of crystalloid used for managing sepsis. Patients administered with normal saline include 29 patients, and the rest of 27 patients have been administered with ringer’s lactate. In the mean study process the extent of fluid resuscitation after 6 hours of administration of crystalloids were observed and recorded in a comparative manner as given n table 3, which shows the difference in various time intervals. Values of Urine pH has not shown much change which has increased from 6.8 (6.5-7.0) to 7.2(7.1-7.6) in ringer’s lactate patients and 7.0(6.7-7.2) to 7.4(7.0-7.6) in normal saline group, Base excess (mmol/L) has been increased from -2.8 ±2.10 to -3.4 ± 2.73 in normal saline and -3.23 ± 2.47 to -4.76±3.10 in ringer’s lactate patients. Serum lactate (mmol/L) has increased from 1.98 ± 0.87 to 2.55 ± 1.354 in normal saline and 2.314 ± 0.542 to 2.87 ± 1.63 in ringer’s group. Bicarbonate (mmol/L) has been increased from 21.67 ± 1.87 to 20.65 ± 9.0in normal saline, 21.45 ± 2.22 to 21.78 ± 3.4 in ringer’s lactate. The sodium levels has increased from 159 ± 2 to 163 ± 4, potassium levels has been increased from 5.9 ± 0.6 to 6.2 ± 0.6, calcium levels has been increased from 8.3 ± 0.3 to 8.8 ± 0.3, chlorine levels has been increased from 120 ± 7 to 127 ± 7 after 6 hours of administration of normal saline in patients. Coming to patients administered with ringer’s lactate, the sodium values has been increased from 153 ± 3 to 155 ± 6, potassium levels has been increased from 5.5 ± 0.3 to 5.7 ± 0.4, calcium levels has been increased from 8.0 ± 0.4 to 8.5 ± 0.7, chloride levels has been increased from 109 ± 5 to 119 ± 6.

9 , 2 , 2019