Normal Saline Versus Plasmalyte in Initial Resuscitation of Trauma Patients

Electrolyte-containing intravenous fluids are routinely administered to patients in the first few hours after acute traumatic injury. Although Normal Saline (0.9% sodium chloride) is commonly used in this setting, it causes a hyperchloremic acidosis that may exacerbate metabolic derangements that occur after acute injury. Plasmalyte A is a solution that more closely matches physiologic electrolyte levels. In this study, we will evaluate whether Plasmalyte A results in less disturbance of the base deficit 24 hours following traumatic injury than does Normal Saline.

Inclusion criteria

• Triaged upon arrival to the hospital as severely injured
• At least 18 years of age
• Meets at least one of the following criteria:

• Intubated or likely to become intubated within 60 minutes of arrival at the hospital
• Likely to need an operation within 60 minutes of arrival
• Received or likely to receive a blood transfusion within 60 minutes of arrival

Exclusion criteria

• Greater than 60 minutes since arrival at the hospital
• Death likely within 48 hours
• Transfer from another hospital
• Pre-existing renal failure requiring dialysis
• Pregnancy
• Prisoner status