Effect of HSRP1 oxygen-carrying solution on early perfusion in rabbits with controlled severe hemorrhagic anemia / 中国输血杂志

【Objective】 To observe the effect of glutaraldehyde polymerized bovine hemoglobin injection (code: HSRP1) oxygen-carrying fluid on early perfusion of severe hemorrhagic anemia in rabbits. 【Methods】 The rabbit model of controlled severe hemorrhagic anemia was established. Twelve modeled rabbits were divided into glutaraldehyde polymerized bovine hemoglobin injection (code: HSRP1) group and sodium lactate ringer′s injection (LR) group, with 6 rabbits in each group(half male and half female). HSPR1 group and LR group were treated with HSRP1 and LR, respectively. The survival rate of experimental rabbits was observed, and the indexes of hemodynamics, venous blood gas, plasma hemoglobin, base surplus, lactic acid and bicarbonate were measured before and after blood loss, as well as each point within 24 h after infusion. 【Results】 The survival rate of HSRP1 group was significantly different from that of LR group (P<0.05); After exsanguination, the mean arterial pressure of each group was significantly different from that before exsanguination (P<0.05), but there was no significant difference between HSPR1 group and LR group after infusion; In the second stage of perfusion, the blood lactate concentration and base excess in the HSRP1 group were significantly different from those in the LR group at each time point (P<0.05), at 2 h after perfusion, the respiratory rate started to differ significantly from that of the LR group (P<0.05), heart rate was significantly different from LR group at 4 h after perfusion(P<0.05); There were no significant differences between HSRP1 group and LR group in plasma venous oxygen partial pressure, venous oxygen saturation and plasma hemoglobin at all time points. 【Conclusion】 HSPR1 is used for severe traumatic hemorrhagic shock in rabbits, and can improve the survival rate of experimental rabbits by providing oxygen to hypoxic tissues and correcting anaerobic metabolism. As a new oxygen-carrying fluid, HSPR1 can correct the oxygen supply balance of patients with severe hemorrhagicanemia in early stage.

Comparison of half-molar sodium lactate and mannitol to treat brain edema in severe traumatic brain injury: A systematic review / 中华创伤杂志(英文版)

PURPOSE@#Hypertonic fluids such as mannitol and half-molar sodium lactate are given to treat intracranial hypertension in patients with severe traumatic brain injury (TBI). In this study, sodium lactate was compared to mannitol in patients with TBI to investigate the efficacy in reducing intracranial pressure (ICP).@*METHODS@#This study was a systematic review with literature research on articles published in any year in the databases of PubMed, ScienceDirect, Asian Journal of Neurosurgery, and Cochrane Central Register of Controlled Trials. The keywords were "half-molar sodium lactate", "mannitol", "cerebral edema or brain swelling", and "severe traumatic brain injury". The inclusion criteria were (1) studies published in English, (2) randomized control trials or retrospective/prospective studies on TBI patients, and (3) therapies including half-molar sodium lactate and mannitol and (4) sufficient data such as mean difference (MD) and risk ratio (RR). Data analysis was conducted using Review Manager 5.3.@*RESULTS@#From 1499 studies, a total of 8 studies were eligible. Mannitol group reduced ICP of 0.65 times (MD 0.65; p = 0.64) and improved cerebral perfusion pressure of 0.61 times (MD 0.61; p = 0.88), better than the half-molar group of sodium lactate. But the half-molar group of sodium lactate maintained the mean arterial pressure level of 0.86 times, better than the mannitol group (MD 0.86; p = 0.09).@*CONCLUSION@#Half-molar sodium lactate is as effective as mannitol in reducing ICP in the early phase of brain injury, superior over mannitol in an extended period. It is able to prevent intracranial hypertension and give better brain tissue perfusion as well as more stable hemodynamics. Blood osmolarity is a concern as it increases serum sodium.

Effects of sodium acetate Ringer solution on electrolytes, blood glucose and lactate levels in pediatric neurosurgery / 中国中西医结合急救杂志

Objective To observe the effect of sodium acetate Ringer solution on serum levels of electrolytes, blood glucose (Glu) and lactic acid (Lac) in peri-operational stage of children undergoing neurosurgery. Methods Forty cases of children prepared to undergo neurosurgery admitted into Hunan Children's Hospital from December 2018 to April 2019 were enrolled, and according to the criteria of American Society of Anesthesiologists (ASA), they were classified into Ⅰ-Ⅱ grade. They were divided into a sodium acetate Ringer solution group and a sodium lactate Ringer solution group by random number table method, 20 cases in each group. Sodium acetate Ringer solution group was given the sodium acetate Ringer solution; sodium lactate Ringer solution group was given the sodium lactate Ringer solution, and both groups used intravenous infusion of their own respective solution at a rate of 10 mL·kg-1·h-1. Arterial blood gas detections were measured after anesthesia induction (T1), 1 hour after administration (T2), 2 hours after administration (T3) and at the end of surgery (T4); the changes in serum levels of electrolyte concentrations, blood Glu and Lac were observed in the patients of two groups. Results With the prolonged operation time, the levels of Glu and Lac in the two groups showed an increasing trend, compared with the levels at T1 and T2 , the levels were increased at T3 and T4 [the sodium lactate ringer solution group: Glu (mmol/L) were 5.85±1.02, 6.95±1.21 vs. 5.28±0.72, 5.20±0.62, and Lac (mmol/L) were 1.53±0.74, 1.91±1.41 vs. 1.23±0.71, 1.38±0.69; sodium acetate ringer solution group: Glu (mmol/L) was 5.44±0.86, 5.85±1.12 vs. 5.05±0.85, 5.14±0.74, Lac (mmol/L) were 1.58±1.31, 1.61±1.23 vs. 1.14±0.65, 1.28±0.95, all P < 0.05], the Lac and Glu levels at T4 in sodium acetate Ringer solution group were significantly lower than those in sodium lactate Ringer solution group (both P < 0.05). There were no statistically significant differences in pH value, Na+, K+ and residual base (BE) levels between the two groups at different time points (all P > 0.05). Conclusion Sodium acetate Ringer solution used in pediatric neurosurgery for more than 2 hours can reduce the blood lactic acid level without rising blood glucoselevel. Therefore, it is more suitable for infusion during pediatric neurosurgery.

A velocidade de infusão da solução poli-iônica intravenosa contendo 84mEq/L de lactato determina a intensidade do efeito alcalinizante em equinos / The intravenous polyionic solution with 84mEq/L of lactate infusion rate determines the intensity of the alkalizing effect in horses

O objetivo deste trabalho foi verificar os efeitos da solução poli-iônica intravenosa contendo 84mEq/L de lactato (L84) sobre os equilíbrios hidroeletrolítico e ácido-base de equinos, quando administrada de forma rápida ou lenta. Cinco equinos sadios adultos receberam a infusão contínua intravenosa da L84, em volume correspondente a 10% do peso corporal, em duas ocasiões: a) infusão rápida (16,66mL/kg/h) durante seis horas; b) infusão lenta (8,33mL/kg/h) durante 12 horas. Amostras de sangue venoso foram colhidas ao início da infusão (hora zero) e três, seis, nove, 12 e 24 horas após, e amostras de urina nas horas zero, seis, 12 e 24. Determinaram-se pH (sanguíneo e urinário), pCO2, HCO3 -, BE, PPT, lactato L, Na+, K+, Cl-, AG, SID, Atot, VVP, densidade urinária e excreções fracionadas urinárias de lactato L, Na+, K+ e Cl-. A L84 provoca efeito alcalinizante iatrogênico de menor magnitude quando administrada de forma lenta, porque os mecanismos renais, atuantes durante o período de infusão, promovem a correção gradativa do desequilíbrio. Pode-se concluir que a infusão de forma lenta da solução L84 em equinos é recomendável nos casos em que se suspeite de acidose metabólica e não seja possível quantificar o grau do desequilíbrio.(AU)

The aim of this study was to investigate the effects of an intravenous polyionic solution containing 84mEq/L of lactate (L84) on the hydroelectrolyte and acid-base balances when administered quickly or slowly in horses. Five healthy adult horses received the L84 solution, in a volume corresponding to 10% of BW, by continuous intravenous infusion, in two instants: a) rapid infusion (16.66mL/kg/h) during 6 hours; b) slow infusion (8.33mL/kg/h) during 12 hours. Venous blood samples were taken at the beginning of the infusion (hour 0) and 3, 6, 9, 12, and 24 hours after. Urine samples were taken at 0, 6, 12, and 24h. pH (blood and urine), pCO2, HCO3-, BE, TPP, L-lactate, Na+, K+, Cl-, AG, SID, Atot, PVV, urine specific gravity, and L-lactate, Na+, K+, and Cl- renal fractional clearance were determined. The L84 solution causes lower magnitude alkalizing effect when administered slowly, due to the gradual correction of the iatrogenic imbalance by the kidneys during the infusion period. The L84 solution infused at a low rate in horses could be recommended in cases where metabolic acidosis is suspected and it is not possible to quantify the imbalance degree.(AU)

Compatible Stability of Levetiracetam Injection with Three Injections / 中国药房

OBJECTIVE:To investigate the compatible stability of Levetiracetam(Lev)injection with 3 injections. METHODS:Each Lev injection 1000 mg mixed with 0.9% Sodium chloride injection 100 mL,5% Glucose injection 100 mL or Sodium lactate Ringer's injection 100 mL respectively. Under the light condition,at 25 ℃,the color and clarification degree of mixtures were ob-served at different time points within 24 h after mixing;pH value and the number of insoluble particles were determined. The contents of related impurities(impurity A,B,C,D,2-hydroxypyridine)and Lev in mixtures were determined by HPLC. RESULTS:Under above condition,all mixtures were colorless clear liquid within 24 h;pH value had no significant change (RSD<1%,n=7);the number of insoluble particles was no more than the range stated in Chinese Pharmacopeia(2015 edition). Impurity B and C were not detected;the contents of other impurities were in line with the requirements of foreign pharmacopeia. No marked change was noted for relative content of Lev(RSD<1%,n=7). CONCLUSIONS:After mixing with 0.9% Sodium chloride injection,5% Glucose injec-tion or Sodium lactate Ringer's injection,Lev injection keep stable at 25℃within 24 h under the light condition.

Discussion on the analytical method of sodium lactate in compound sodium lactate and glucose injection in chinese pharmacopoeia / 中国药学杂志

OBJECTIVE: To establish a RP-HPLC method for the determination of sodium lactate in compound sodium lactate and glucose injection and provide reference for revision of method recorded in Chinese Pharmacopoeia. METHODS: The separation was performed on a Shim-pack VP-ODS C18 analytical column (4.6 mm×250 mm, 5 μm), and the mobile phase was formic acid-dicyclo-hexylamine-water (1:1:998, V/V) at a flow rate of 1.0 mL·min-1. The detection wavelength was set at 210 nm and the column temperature was maintained at 40℃. The loading volume was 20 μL. The RP-HPLC method and the cation exchange resin method adopted by Chinese Pharmacopoeia were both used to determine the content of sodium lactate in compound sodium lactate and glucose injection, and the results were compared. RESULTS: The linear range of the RP-HPLC method was 0.51-6.07 mg·mL-1 (r=0.9999). The average recovery was 99.47% (RSD=0.75%, n=9). CONCLUSION: The established method of RP-HPLC can be used for the determination of sodium lactate in compound sodium lactate and glucose injection.

Effects of infusion with different kinds of liquid on blood coagulation and fibrinolysis in rabbits with acute respiratory distress syndrome / 中国中西医结合急救杂志

Objective To observe the influences of infusion with normal saline (NS), Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride on blood coagulation/fibrinolysis in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hit of oleic acid (OA) and lipopolysaccharide (LPS).Methods According to random number table, 40 healthy adult male rabbits were divided into sham operation, model, NS, Ringer and colloid groups (8 rabbits in each group). The ARDS model was replicated by sequential injection of OA (0.1 mL/kg) and LPS (500μg/kg) into the ear marginal vein of rabbit. Immediately after injection of LPS, the NS, Ringer and colloid groups were treated by intravenous infusion of NS, lactate Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride, respectively at a speed of 7 mL·kg-1·h-1 for 210 minutes. There was no liquid infusion in model and sham operation groups. At 30 minutes and 210 minutes after LPS injection, the arterial blood was collected and the partial pressure of arterial blood oxygen (PaO2) was measured and the oxygenation index (PaO2/FiO2) was calculated. At 5, 30, 120 and 210 minutes after LPS injection, venous blood was collected, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib), antithrombase Ⅲ (AT-Ⅲ), serum procollagen peptide Ⅲ (PⅢP), tissue plasminogen activator (t-PA) were measured, respectively. After the rabbits were killed by bloodletting at the end of experiment, the lung tissues were obtained, collagen Ⅰ and collagen Ⅲ in lung tissues were detected by immunohistochemistry staining, lung wet/dry weight ratio (W/D) and pathologic score of lung tissues were calculated.Results Compared with sham operation group, at 30 minutes and 210 minutes in model group the levels of PaO2/FiO2 were significantly decreased, and the lung W/D ratios as well as pathologic scores of pulmonary tissues were increased. In model group, the APTT began from 30 minutes while the PT began from 120 minutes to gradually prolong, and the value of Fib was progressively decreased; with a tendency of mild decline, the levels of AT-Ⅲ at all time-points were lower in model group than those in sham operation group (allP < 0.05). The levels of t-PA and PⅢP at all time-points were significantly higher, and the expression levels of collagen Ⅰ and collagen Ⅲ in model group were obviously more strengthened compared to those in sham operation group. Among the three infusion groups, the improvement degrees of PaO2/FiO2, lung W/D ratio and pathologic score of pulmonary tissues were the highest in NS group, lowest in colloid group, and no significant changes in Ringer group. APTT in NS group except 120 minutes was longer, the APTTs at 30 minutes and 210 minutes were shorter in NS group than those in model group (s: 30 minutes: 52.26±18.65 vs. 76.22±16.64, 120 minutes: 90.60±10.66 vs. 83.01±15.88, 210 minutes: 70.44±17.80 vs. 77.04±13.32, allP < 0.05); the prolongation of amplitudes of APTT in Ringer and colloid groups were greater than that in model group, particularly in colloid group, the greatest; the PT in three infusion groups were gradually prolonged, and at 120 minutes and 210 minutes were all longer than that in model group (allP < 0.05). The levels of Fib in those treatment groups were all gradually decreased, the amplitude descent of Fib in NS group was the smallest and that in colloid group, the biggest; the levels of AT-Ⅲ in three infusion groups and model group had similar decline tendency, the descending amplitude being the most significant in colloid group. The levels of t-PA at all time-points in the three treatment groups were lower than those in model group (allP < 0.05). The levels of PⅢP in serum at all time-points were lower in Ringer and NS groups than those in model group (μg/L: Ringer group: 5 minutes: 250.60±36.53 vs. 285.77±65.55, 30 minutes: 248.73±44.41 vs. 302.16±37.73, 120 minutes: 249.14±43.16 vs. 296.09±38.64, 210 minutes: 246.62±44.72 vs. 295.45±42.75; NS group: 5 minutes: 261.89±50.74 vs. 285.77±65.55, 30 minutes: 247.71±50.40 vs. 302.16±37.73, 120 minutes: 246.58±42.27 vs. 296.09±38.64, 210 minutes: 222.73±18.51 vs. 295.45±42.75, allP < 0.05), but there were no statistically significant differences between the colloid group and model group. The expression levels of collagen Ⅰ and collagen Ⅲ in all liquid infusion groups were lower than those in model group (P < 0.05 orP < 0.01), whereas in colloid group were higher than those in NS and Ringer groups (allP < 0.05).Conclusions The infusion of NS, lactate Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride have different influences on the blood coagulation function in ARDS rabbits, among which the effect of NS is the least, while of the hydroxyethyl starch 130/0.4 sodium chloride appears the greatest. The infusion of these three liquids can all decrease the pulmonary fibrous tissue in rabbits with ARDS, and in the mean time can alleviate the lung tissue pathological lesion for a certain degree, the effect of NS and Ringer solution being greater than that of hydroxyethyl starch 130/0.4 sodium chloride.

Optimization of Preparation Technology of Compound Sodium Lactate Injections for Improvement of Clar-ity / 中国药师

Objective:To optimize the preparation technology of compound sodium lactate injections for the improvement of clari-ty. Methods:The orthogonal test was adopted to screen the best preparation conditions using four influencing factors including the de-carburization temperature of the concentrated solution (A), pH value of the concentrated solution (B), decarburization time of the concentrated solution ( C) and the filling temperature of the injections ( D) with 3 levels for each, and the clarity of the injections as the index. Results:The best preparation conditions were as follows:the decarburization temperature was 60℃, pH value of the con-centrated solution was 6. 5, the decarburization time was 20minute and the filling temperature was 50℃. Conclusion: The optimal process can improve the clarity of compound sodium lactate injections.

Volume kinetics of lactated Ringer's solution during induction of epidural versus general anesthesia in elderly patients / 中华麻醉学杂志

Objective To compare the volume kinetics of lactated Ringer' s solution during induction of general and epidural anesthesia in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,aged 66-86 yr,weighing 45-86 kg,undergoing elective surgery,were studied.In epidural anesthesia group (n =20),lactated Ringer' s solution was infused intravenously starting from 10 min before epidural anesthesia was performed with local anesthetics.In general anesthesia group (n =20),lactated Ringer' s solution 1000 ml was infused intravenously over 60 min starting from 20 min before induction of anesthesia.Arterial blood samples were obtained every 5 min for measurement of hemoglobin concentrations.The plasma dilution,volume increase,and volume expansion efficacy were calculated.Results The plasma dilution,volume increase and volume expansion were significantly higher at 30-60 min of lactated Ringer' s solution infusion in general anesthesia group than in epidural anesthesia group (P ＜ 0.05 or 0.01).Conclusion The volume expansion of lactated Ringer' s solution is greater in elderly patients during induction of general anesthesia than that during induction of epidural anesthesia.

Influence of hydroxyethylstarch 200/0.5 on hemodynamic and coagulation in hemodilution for paediatrics patients / 中国基层医药

Objective To study the influence of hydroxyethylstarch 200/0.5 on hemodynamic and coagulation in hemodilution for paediatrics patients(AHH).Methods 64 paediatrics patients who would receive AHH were selected.All patients were randomly divided into HES group(received HES 200/0.5)and control group(received sodium lactate Ringer's),32 patients in each group.Hemodynamic efficacy and coagulation indexes were recorded before AHH(T0),30 min post-AHH(T1) and 60 min post-AHH(T2).Results There were no sinificant differences in MAP,HR,CVP,INR,APTT,CT and FIB compared with T0 or between groups.RBC,Hct and Hb were significantly lower compared with T0,but no significant differences were observed between groups.CI and PT were significantly higher compared with T0,but no significant differences were observed between groups.Conclusion There were no negative effects on hemodynamic efficacy and coagulation in paediatrics patients treating with HES 200/0.5.

Cultural Conditions for Production of Glutathione by Mutant Saccharomyces J-X25 / 中国生物工程杂志

The production conditions of glutathione with shaking flask fermentation by the mutant Saccharomyces J-X25, a methionine-defected strain were studied, and the optimum culture conditions are as follows: initial pH6. 0, temperature 30℃, 100ml in 500ml flask, the inoculum size 10% and agitation rate 220r/min. The emphasis was on the stimulating effect on the cells by dioxogen and the sodium lactate as surfactant. Both of which were added at the logarithmic phase of fermentation, and the GSH production was up to 0. 253g/L , 52% higher than the control without the additions. Compared with the production of GSH initial strain that by the mutant in optimum conditions was increased by 79%.

Compatible Stability of Ceftriaxone Sodium with Calcium-containing Solutions / 中国药房

OBJECTIVE:To study the compatible stability of Ceftriaxone Sodium with Compound Sodium Chloride Injection or Sodium Lactate Ringer's Injection and study the compatible stability of the simulated in vivo peak concentration of ceftriaxone sodium with instant high concentration of calcium gluconate ion injection. METHODS: The concentration of Ceftriaxone Sodium in the mixture was determined by HPLC,meanwhile,the changes of the mixture in appearance,pH value,and the insoluble particles at room temperature were observed. RESULTS: At 0～2 hours,the mixture of Ceftriaxone Sodium and Compound Sodium Chloride Injection was clear in appearance;however,at 2 hours,it was white cloudy macroscopically,and its pH valued increased,ceftriaxone sodium content decreased and insoluble particles increased. The ceftriaxone sodium content reduced when mixed with sodium lactate ringer's injection. After mixing of simulated in vivo peak concentration of ceftriaxone sodium with instant high concentration of calcium gluconate ion injection,the appearance of the mixture was stable but the concentration of Ceftriaxone Sodium reduced slightly. CONCLUSION: Ceftriaxone Sodium can't be used in combination with Compound Sodium Chloride Injection or Sodium Lactate Ringer's Injection. Whether it is suitable to infuse calcium gluconate when ceftriaxone sodium (iv gtt) reached peak concentration remains to be confirmed in future study.

Enzyme electrode for the determination of sodium lactate in sodium lactate injection / 中国药学杂志

OBJECTIVE: To determine the concentration of sodium L-lactate in sodium lactate injection. METHODS: Lactic oxidase was immobilized at a hydrogen peroxide electrode and the enzyme electrode was used for the amperometric determination of sodium L-lactate in sodium lactate injection. Sodium D, L-lactate in injection was analyzed by that technique according to Chinese Pharmacopoeia. RESULTS: The quantity of sodium L-lactate was about 10% in total amount of sodium D, L-lactate in sodium lactate injection. CONCLUSION: Sodium L-lactate in sodium lactate injection could be determined specially, rapidly and inexpensively.