Normal Saline Versus Plasmalyte in Initial Resuscitation of Trauma Patients

The purpose of this study is to determine whether an intravenous salt solution called "Plasmalyte" causes less abnormality of the body's acid levels than a solution called "Normal Saline."

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.

• Wounds and Injuries
• Multiple Trauma
• Disorder of Fluid Balance

• Other: Plasmalyte A
  Intravenous fluid
• Other: Normal Saline
  Intravenous fluid

• Experimental: Plasmalyte
  Administration of Plasmalyte A as the standard intravenous fluid during the first 24 hours after arrival to the hospital
  Intervention: Other: Plasmalyte A
• Active Comparator: Normal Saline
  Administration of Normal Saline as the standard intravenous fluid during the first 24 hours after arrival to the hospital
  Intervention: Other: 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:

  1. Intubated or likely to become intubated within 60 minutes of arrival at the hospital
  2. Likely to need an operation within 60 minutes of arrival
  3. 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