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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A balanced view of balanced solutions
Critical Care, Volume 14, No. 5, Article 325, Year 2010
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Description
The present review of fluid therapy studies using balanced solutions versus isotonic saline fluids (both crystalloids and colloids) aims to address recent controversy in this topic. The change to the acid-base equilibrium based on fluid selection is described. Key terms such as dilutional-hyperchloraemic acidosis (correctly used instead of dilutional acidosis or hyperchloraemic metabolic acidosis to account for both the Henderson-Hasselbalch and Stewart equations), isotonic saline and balanced solutions are defined. The review concludes that dilutional-hyperchloraemic acidosis is a side effect, mainly observed after the administration of large volumes of isotonic saline as a crystalloid. Its effect is moderate and relatively transient, and is minimised by limiting crystalloid administration through the use of colloids (in any carrier). Convincing evidence for clinically relevant adverse effects of dilutional-hyperchloraemic acidosis on renal function, coagulation, blood loss, the need for transfusion, gastrointestinal function or mortality cannot be found. In view of the long-term use of isotonic saline either as a crystalloid or as a colloid carrier, the paucity of data documenting detrimental effects of dilutional-hyperchloraemic acidosis and the limited published information on the effects of balanced solutions on outcome, we cannot currently recommend changing fluid therapy to the use of a balanced colloid preparation. © 2010 BioMed Central Ltd.
Authors & Co-Authors
Guidet, Bertrand R.
France, Paris
Inserm
France, Paris
Sorbonne Université
France, Paris
Hôpital Saint-antoine
Soni, Neil
United Kingdom, London
Chelsea and Westminster Hospital
United Kingdom, London
Imperial College London
Della-Rocca, Giorgio
Italy, Udine
Policlinico Universitario, Udine
Kozek, Sibylle
Austria, Vienna
Medizinische Universität Wien
Vallet, Benoît
France, Lille
Université de Lille
Annane, Djillali
France, Versailles
Université de Versailles Saint-quentin-en-yvelines
James, Michael Frank M.
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 7
Authors: 7
Affiliations: 10
Identifiers
Doi:
10.1186/cc9230
ISSN:
13648535
e-ISSN:
1466609X
Research Areas
Noncommunicable Diseases