Surgery>>>>>Fluid and Electrolyte Management of the Surgical Patient
Question 30#

A victim of a motor vehicle accident arrives in hemorrhagic shock.

His arterial blood gases are:

• pH= 7.25
• Po₂= 95 mm Hg
• Pco₂= 25 mm Hg
• HC03 = 15 mEq/L

The patient's metabolic acidosis would be treated best with:

A. Ampule of sodium bicarbonate
B. Sodium bicarbonate infusion
C. Lactated Ringer solution
D. Hyperventilation

Correct Answer is C

Comment:

In patients suffering from hemorrhagic shock, the presence of a metabolic acidosis early in the postresuscitative period is indicative of tissue hypoxia due to persistent inadequate tissue perfusion. Attempts to correct this problem by administering an alkalizing agent will not solve the basic problem. 

However, proper volume replacement by means of a balanced salt solution such as lactated Ringer solution will restore perfusion and correct the metabolic acidosis by ending anaerobic metabolism.