A balanced view of balanced solutions

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dc.contributor.authorGuidet, Bertranden_ZA
dc.contributor.authorSoni, Neilen_ZA
dc.contributor.authorRocca, Giorgioen_ZA
dc.contributor.authorKozek, Sibylleen_ZA
dc.contributor.authorVallet, Benoiten_ZA
dc.contributor.authorAnnane, Djillalien_ZA
dc.contributor.authorJames, Mikeen_ZA
dc.date.accessioned2015-11-11T11:56:55Z
dc.date.available2015-11-11T11:56:55Z
dc.date.issued2010en_ZA
dc.description.abstractThe 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.en_ZA
dc.identifier.apacitationGuidet, B., Soni, N., Rocca, G., Kozek, S., Vallet, B., Annane, D., & James, M. (2010). A balanced view of balanced solutions. <i>Critical Care</i>, http://hdl.handle.net/11427/14867en_ZA
dc.identifier.chicagocitationGuidet, Bertrand, Neil Soni, Giorgio Rocca, Sibylle Kozek, Benoit Vallet, Djillali Annane, and Mike James "A balanced view of balanced solutions." <i>Critical Care</i> (2010) http://hdl.handle.net/11427/14867en_ZA
dc.identifier.citationGuidet, B., Soni, N., Della Rocca, G., Kozek, S., Vallet, B., Annane, D., & James, M. (2010). A balanced view of balanced solutions. Crit Care, 14(5), 325.en_ZA
dc.identifier.ris TY - Journal Article AU - Guidet, Bertrand AU - Soni, Neil AU - Rocca, Giorgio AU - Kozek, Sibylle AU - Vallet, Benoit AU - Annane, Djillali AU - James, Mike AB - 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. DA - 2010 DB - OpenUCT DO - 10.1186/cc9230 DP - University of Cape Town J1 - Critical Care LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - A balanced view of balanced solutions TI - A balanced view of balanced solutions UR - http://hdl.handle.net/11427/14867 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14867
dc.identifier.urihttp://dx.doi.org/10.1186/cc9230
dc.identifier.vancouvercitationGuidet B, Soni N, Rocca G, Kozek S, Vallet B, Annane D, et al. A balanced view of balanced solutions. Critical Care. 2010; http://hdl.handle.net/11427/14867.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Anaesthesiaen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2010 BioMed Central Ltden_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceCritical Careen_ZA
dc.source.urihttp://www.ccforum.com/en_ZA
dc.titleA balanced view of balanced solutionsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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