Effect Of Sodium Potassium Magnesium Calcium Glucose Injection On Circulation And Prognosis Of Patients With Sepsis Shock After Fluid Resuscitation

Objective:This experiment was to observe the effect of sodium potassium magnesium calcium glucose injections on improving circulation and prognosis of patients with sepsis shock during fluid resuscitation.In addition,an animal model of endotoxin-induced sepsis shock was constructed to further verify the effect of sodium potassium magnesium calcium and glucose injections on improving circulation.Methods:Clinical research:Eighty patients with septic shock at the Affiliated Hospital of Qingdao University were randomly divided into normal saline group(NS group)and sodium potassium magnesium calcium glucose injections group(LJ group)40 cases each.Saline group was given normal saline for fluid resuscitation,sodium potassium magnesium calcium glucose injections group was given sodium potassium magnesium calcium glucose injections for rehydration.Both groups of liquids were rehydrated according to 30ml/kg.The volume responsiveness of the patient was dynamically assessed and the fluid resuscitation was appropriately performed.The two groups were compared of 3 hours of recovery,6 hours of recovery,12 hours of recovery of heart rate,blood pressure,blood lactate,arterial oxygen saturation,central venous pressure,and respiration before recovery.After the 1st,3rd and 5thday of resuscitation,We also compared the amount of fluid taken in and out on,blood electrolyte,blood glucose,the incidence of hypoglycemia,blood transfusion volume,supplementary colloid volume,sequential organ failure score(SOFA),total ICU stay,total mechanical ventilation time,as well as the number of acute kidney injury,multiple organ failure,and new renal replacement therapy.Experimental Study:Male clean grade 24 Japanese white rabbits,weighing 2.5±1.3Kg,they were divided into sepsis shock+saline group(S-NS group),sepsis shock+sodium potassium magnesiumcalcium glucose injections group(S-LJ group)according to random envelope method,and 12 in each group.The animal model of sepsis shock was prepared by ear vein injection of lipopolysaccharide(LPS).In the first three hours,according to the group given normal saline or sodium potassium magnesium calcium glucose injections at the speed of 30ml/kg/h for liquid resuscitation.Before recovery,3 hours for recovery,6 hours for recovery,rabbit blood pressure,heart rate,and central venous pressure were recorded.At the same time,blood samples were taken for the detection of lactic acid,TNF,IL-8 and blood potassium,serum sodium,and blood chlorine.Results:Clinical research:1.there was no significant difference in the recovery of heart rate,mean arterial pressure,arterial oxygen saturation,lactic acid,infusion volume,blood transfusion volume,colloid volume between the LJ group and the NS group.2.Sodium potassium magnesium calcium glucose injections are significantly different from normal saline in norepinephrine consumption.3.Infusion of sodium potassium magnesium calcium glucose injections to patients with sepsis shock did not cause an increase in blood glucose abnormalities.Fourth,infusion of normal saline during fluid resuscitation in patients with sepsis do result in hyperchloremia and hypernatremia.Experimental Study:1.There was significant difference in heart rate,mean arterial pressure and lactic acid in septic shock + LJ group 3 hours after administration compared with sepsis shock +saline group.There was no significant difference between the time of administration and6 hours after administration.The difference was not statistically significant.2.There was no significant difference in TNF-α and IL-8 before and 3 hours and 6hours after administration between sepsis shock+saline group and sepsis shock plus LJ group.The difference was not statistically significant.3.During the liquid resuscitation of rabbits with sepsis shock,the serum potassium and sodium in the sepsis shock + saline group and the sepsis shock + LJ group remained basically stable.Serum chloride in the sepsis shock + saline group exceeded the normal range and hyperchloremia developed.Conclusion:1.In the liquid resuscitation treatment of patients with sepsis sodium potassium,magnesium calcium and glucose injections can effectively improve the hemodynamics,maintain the stability of blood electrolytes,and are more suitable for liquid resuscitation of sepsis shock than normal saline.2.The use of physiological saline for liquid resuscitation will lead to hyperchloremia in patients with sepsis shock.