Effect of Sodium Bicarbonate Ringer's Solution on Early Renal Function in Patients with Traumatic Brain Injury After Surgery

doi:10.16048/j.issn.2095-5561.2025.01.15

Abstract：Objective To investigate the effect of sodium bicarbonate Ringer's solution on early renal function in patients with traumatic brain injury (TBI) after surgery. Methods From November 2023 to April 2024, 80 non-penetrating TBI patients who underwent surgery within 24 hours of injury were selected from the Northern Theater Command General Hospital. There were 48 males and 32 females, with a mean age of (57.4±13.1) years, ranging from 18 to 64 years. According to the type of crystalloid fluid used during surgery, the patients were divided into two groups: the sodium bicarbonate group (using sodium bicarbonate Ringer's solution, n=40) and the lactate group (using lactated Ringer's solution, n=40). Clinical data during surgery, serum creatinine clearance before and 1, 2, and 3 days after surgery, and arterial lactate levels, potassium levels, and oxygenation index at different time points [upon entering the operating room (T0), after anesthesia induction (T1), at the end of surgery (T2), and within 12 hours post-surgery (T3)] were analyzed. Additionally, ventilator use time, ICU stay duration, total hospitalization time, incidence of acute kidney injury (AKI), and short-term improvement rate of prognosis were compared between the two groups. Results At T2 and T3, lactate levels in both groups were significantly higher than at T0, with statistical significance (P < 0.05). Moreover, lactate levels at T2 and T3 in the sodium bicarbonate group were significantly lower than those in the lactate group (P < 0.05). In the subgroup of severe TBI, the serum creatinine clearance in the sodium bicarbonate group was significantly higher than that in the lactate group on postoperative days 1, 2, and 3 (P < 0.05). The ICU hospitalization time and total hospitalization time in the sodium bicarbonate group were significantly shorter than those in the lactate group (P < 0.05). Additionally, the incidence of AKI after surgery in the sodium bicarbonate group was significantly lower than that in the lactate group (P < 0.05). Conclusion Compared with traditional lactated Ringer's solution, sodium bicarbonate Ringer's solution can better maintain the intraoperative internal environment stability in TBI patients, shorten the hospitalization time, and provide renal protection for patients with severe TBI, thereby reducing the incidence of postoperative AKI.