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Related Experiment Videos

(Ab)normal saline and physiological Hartmann's solution: a randomized double-blind crossover study.

Fiona Reid1, Dileep N Lobo, Robert N Williams

  • 1Section of Surgery, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH, UK.

Clinical Science (London, England : 1979)
|January 10, 2003
PubMed
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Intravenous 0.9% saline causes greater fluid retention and hyperchloremia than Hartmann's solution. Hartmann's solution promotes faster fluid and sodium excretion, with a more physiological electrolyte balance.

Area of Science:

  • Clinical Medicine
  • Physiology
  • Biochemistry

Background:

  • Intravenous fluid resuscitation is a cornerstone of medical treatment.
  • 0.9% saline and Hartmann's solution are commonly used crystalloid solutions.
  • Understanding their differential physiological effects is crucial for optimal patient management.

Purpose of the Study:

  • To compare the effects of 2-litre bolus infusions of 0.9% saline and Hartmann's solution on fluid balance and biochemical parameters in healthy subjects.
  • To investigate the impact of these solutions on serum albumin, haematocrit, and urinary biochemistry.
  • To evaluate differences in fluid and electrolyte excretion between the two infusates.

Main Methods:

  • Double-blind, crossover study design involving nine healthy male volunteers.

Related Experiment Videos

  • Administration of 2-litre intravenous infusions of 0.9% saline and Hartmann's solution over 1 hour on separate occasions.
  • Serial measurements of body weight, haematocrit, and serum biochemistry for 6 hours post-infusion.
  • Analysis of pooled post-infusion urine for biochemical composition.

    • Main Results:

    • Greater and more sustained blood and plasma volume expansion observed after 0.9% saline compared to Hartmann's solution.
    • Significantly higher fluid retention (56% vs. 30%) and slower urine and sodium excretion following 0.9% saline infusion.
    • Development of sustained hyperchloremia (>105 mmol/l) after 0.9% saline, unlike Hartmann's solution.
    • Lower serum bicarbonate levels and a longer time to first micturition after 0.9% saline administration.

    Conclusions:

    • 0.9% saline leads to more prolonged fluid retention and adverse electrolyte changes (hyperchloremia) compared to Hartmann's solution.
    • Hartmann's solution facilitates more rapid excretion of water and sodium, likely due to its more physiological sodium-to-chloride ratio.
    • These findings suggest that Hartmann's solution may be preferable for fluid resuscitation when avoiding hyperchloremia is a clinical goal.