A balanced view of balanced solutions


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dc.contributor.author Guidet, Bertrand en_ZA
dc.contributor.author Soni, Neil en_ZA
dc.contributor.author Rocca, Giorgio en_ZA
dc.contributor.author Kozek, Sibylle en_ZA
dc.contributor.author Vallet, Benoit en_ZA
dc.contributor.author Annane, Djillali en_ZA
dc.contributor.author James, Mike en_ZA
dc.date.accessioned 2015-11-11T11:56:55Z
dc.date.available 2015-11-11T11:56:55Z
dc.date.issued 2010 en_ZA
dc.identifier.citation Guidet, 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.uri http://hdl.handle.net/11427/14867
dc.identifier.uri http://dx.doi.org/10.1186/cc9230
dc.description.abstract 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. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source Critical Care en_ZA
dc.source.uri http://www.ccforum.com/ en_ZA
dc.title A balanced view of balanced solutions en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2010 BioMed Central Ltd en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Anaesthesia en_ZA
uct.type.filetype Text
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License