Glucose monohydrate 20g / Sodium chloride 3.5g / Sodium bicarbonate 2.5g oral powder sachets

BackgroundEx vivo lung perfusion (EVLP) supports assessment and rehabilitation of donor lungs. It runs as a closed circuit, so electrolytes and metabolites accumulate over the duration of perfusion. This systematic review investigates the impact of various dialysis or perfusate exchange (PE) techniques on electrolyte balance, inflammation and lung function during EVLP.MethodsA literature search of PubMed and Embase was conducted from database inception to September 17, 2025. We included all articles describing human or animal studies that tested dialysis or PE during EVLP. Outcomes included electrolytes, lactate, pH, edema formation, lung performance characteristics, and inflammatory markers.ResultsFive studies met the inclusion criteria, one human and four porcine models, with a total of 57 subjects. Across studies, dialysis consistently improved solute clearance, lowering sodium, potassium, and chloride, while increasing calcium and glucose, reducing lactate accumulation, and maintaining physiologic pH. PE did not sustain physiologic pH and had limited impact on electrolyte homeostasis, with only transient effects on lactate. No differences were observed in lung function parameters including oxygenation, compliance, and airway pressure. Pro-inflammatory cytokine production was largely unchanged, however, interleukin (IL)-10 was elevated with dialysis in several studies.ConclusionDuring EVLP, dialysis stabilized acid-base status and metabolites. These biochemical gains did not translate into consistent improvements in oxygenation or compliance. Smaller dialysis membranes were associated with higher pulmonary artery pressure (PAP) and increased cytokine profile. Future studies should extend EVLP duration with perfusate clearance to evaluate whether perfusate clearance strategies provide additional benefits with longer duration preservation.

Abstract licence: CC BY-NC-ND

ObjectiveThe choice of crystalloid solution considerably affects perioperative outcomes in neurosurgery. This study aimed to evaluate the effects of Plasma-Lyte 148 and 0.9% saline on acid-base and hydroelectrolyte balance in adults undergoing elective neurosurgical procedures.MethodsA double-blind randomized controlled trial was conducted at Botucatu Medical School from November 2019 to May 2020. Patients received either Plasma-Lyte 148 or 0.9% saline at a maintenance rate of 2mL/kg/h, with additional bolus guided by mean arterial pressure and pulse pressure variation. The primary endpoint was arterial pH at the end of surgery.ResultsSixty-eight patients (33 in the Plasma-Lyte 148 group and 35 in the saline group) completed the study. The total median volumes administered (1st-3rd quartiles) were 2,227 (1,416-3,000) and 3,000 (2,000-4,000) mL in the Plasma-Lyte 148 and saline groups, respectively (p=0.107). At procedure completion, Plasma-Lyte 148 demonstrated superior acid-base homeostasis with significantly higher pH (7.39±0.04 versus 7.35±0.05, pConclusionPlasma-Lyte 148 provides superior acid-base homeostasis compared to 0.9% saline in patients undergoing neurosurgery, with significantly better pH, bicarbonate, and base excess profiles while avoiding hyperchloremia. These findings support the preferential use of balanced crystalloids in neurosurgical practice, aligning with current evidence favoring Plasma-Lyte 148 for optimal perioperative fluid management. ReBEC platform registration number: RBR-2592-hd.

Abstract licence: CC BY

Abstract Background Hyperkalemia is a frequently observed electrolyte imbalance in dehydrated neonatal diarrheic calves that can result in skeletal muscle weakness and life-threatening cardiac conduction abnormalities and arrhythmias. Hypothesis Intravenous administration of a small-volume hypertonic NaHCO3 solution is clinically more effective in decreasing the plasma potassium concentration (cK) in hyperkalemic diarrheic calves than hypertonic NaCl or glucose solutions. Animals Twenty-two neonatal diarrheic calves with cK >5.8 mmol/L. Methods Prospective randomized clinical trial. Calves randomly received either 8.4% NaHCO3 (6.4 mL/kg BW; n = 7), 7.5% NaCl (5 mL/kg BW; n = 8), or 46.2% glucose (5 mL/kg BW; n = 7) IV over 5 minutes and were subsequently allowed to suckle 2 L of an electrolyte solution. Infusions with NaHCO3 and NaCl provided an identical sodium load of 6.4 mmol/kg BW. Results Hypertonic NaHCO3 infusions produced an immediate and sustained decrease in plasma cK. Hypertonic glucose infusions resulted in marked hyperglycemia and hyperinsulinemia, but cK remained unchanged for 20 minutes. Between 30 and 120 minutes after initiation of treatment, the most marked decrements in cK from baseline occurred in group NaHCO3, which were significantly (P < .05) larger during this period of time than in calves in group NaCl, but not group glucose. After 120 minutes, the mean decrease in cK from baseline was −26 ± 10%, −9 ± 8%, and −22 ± 6% in groups NaHCO3, NaCl, and glucose, respectively. Conclusions/Clinical Importance Small-volume hypertonic NaHCO3 infusions appear to have clinical advantages for the rapid resuscitation of hyperkalemic diarrheic calves, compared to hypertonic NaCl or glucose solutions.

Abstract licence: CC BY-NC 4.0