Electrolyte Mass Balance During CVVH: Lactate vs. Bicarbonate‐Buffered Replacement Fluids

Figures & data

Table 1. Demographics of Study Patients

	Age	Sex	Diagnosis	SAPS‐II	INR	Bil	ALT	Study point	Outcome
1	61	F	Liver transplant	50	1.5	217	34	2 days	Alive
2	72	M	VF arrest	82	1.2	20	47	7 days	Alive
3	43	M	Acute pancreatitis	70	1.1	273	41	3 days	Died
4	70	F	Acute pancreatitis	34	1.1	18	59	1 days	Died
5	59	M	Liver transplant	71	1.0	297	48	9 days	Alive
6	58	F	Cellulitis, septic shock	35	1.4	7	5	2 days	Died
7	44	F	Intra‐abdominal sepsis	38	1.2	19	7	1 day	Died
8	39	M	Liver transplant	29	0.9	253	49	9 days	Alive

VF: ventricular fibrillation, INR: prothrombin time international normalized ratio, Bil: Bilirubin (µg/L), ALT: alanine aminotransferase (U/L), Study point: duration from the beginning of continuous veno‐venous hemofiltration to the first day of the study.

Table 2. Solute Concentrations in Bicarbonate and Lactate Buffers (mmol/L)

Solute	Bic‐CVVH	Lac‐CVVH
Sodium	140	140
Potassium	3.7	3.7
Calcium	1.75	1.6
Magnesium	0.5	0.8
Chloride	113.2	102.7
Phosphate	0	0
Bicarbonate	32	0
Lactate	3	46
Glucose	0	10.8

Table 3. Electrolyte Concentrations in Blood Pre‐ and Post‐CVVH (mmol/L)

		Na	Cl	K	Mg	Phos
Bicarbonate	Pre	132.9 ± 1.9	102.6 ± 2.8	4.1 ± 1.1	1.04 ± 0.12	0.95 ± 0.37
	Post	133.1 ± 1.9	102.9 ± 1.8	4.3 ± 1.0	1.06 ± 0.14	0.97 ± 0.36
Lactate	Pre	133.1 ± 2.3	101.8 ± 2.7	4.0 ± 0.3	1.14 ± 0.19	0.91 ± 0.33
	Post	133.2 ± 2.1	102.4 ± 2.6	4.0 ± 0.4	1.06 ± 0.15	0.96 ± 0.34

Na: sodium, Cl: chloride, K: potassium, Mg: magnesium, Phos: phosphate.

Figure 1. Graphic representation of electrolyte mass transfer with bicarbonate‐buffered fluids and lactate‐buffered fluids. Na = sodium, Cl = chloride, K = potassium, Mg = magnesium, Phos = phosphate. The p values refer to the difference in mass balance for chloride and magnesium with bicarbonate or lactate‐based replacement fluids.