Abstract

CASTELLON SEJAS, Virginia; GUEVARA CRESPO, Carlos; ROSA BUSTAMANTE, Carmen  and  SEJAS CLAVIJO, Jacquie María. Electrolyte changes and acid-base in patients undergoing nephrectomy for kidney donation in the center medic-surgical Bolivian-Belgian. Gac Med Bol [online]. 2010, vol.33, n.1, pp.12-16. ISSN 1012-2966.

The changes in acid-base balance caused by of a (0,9%) saline solution during anesthesia and surgery are poorly char-acterized. The authors evaluated these phenomena in kitney donors. It was carried out a prospective, descriptive, ob-servational and longitudinal study where 12 patients were included to nephrectomy protocol related to live donor's transplant that is taken to I dig in the Center I Prescribe Surgical Bolivian - Belgian in the period between September -October of 2008. We took samples of blood of the radial artery to measure pH, PaCO2, PAO2, concentrations of sodium, potassium, chlorine and bicarbonate serie in 3 different moments of the procedure surgical-anesthetic (basal,clamping and emersión). The anión gap was calculated with the following formula: [Na+] - [Cl -] + [HCO3 -]. The infusión of iso-tonic saline solution (0.9%) it caused decrease of the pH, bicarbonate serie and base déficit (p <0.001). The anión gap stayed constant and the chlorine serie increment lightly without statistical significance. The time of infusión was of 14±24 min. until the clamping of the renal hilio. The infusión of 15 ± 3.7 ml/kg/H of isotonic saline solution (0.9%) lead to metabolic acidosis associated to hyper-chloremia and to an normal anión gap it is considered as acidosis hyperchloremic.

Keywords : Balance acid-base; nefrectomy; kidney transplant; hyperchloremia; metabolic acidosis; anión gap.

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