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0.9% saline induced hyperchloremic acidosis.

Megan E Barker1

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|March 14, 2015
PubMed
Summary
This summary is machine-generated.

0.9% saline infusions can worsen acidosis due to increased chloride levels. Chloride-restrictive fluids like Plasmalyte may improve patient outcomes by reducing acid-base disturbances in acute care settings.

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Medical Education

Background:

  • Intravenous fluid administration is critical in acute care.
  • 0.9% saline is a common infusate but can lead to hyperchloremia.
  • Hyperchloremia is associated with acid-base disturbances and adverse patient outcomes.

Purpose of the Study:

  • To evaluate complications associated with 0.9% saline infusions.
  • To compare the effects of 0.9% saline versus balanced crystalloids (Lactated Ringer, Plasmalyte) on acid-base balance.
  • To determine if chloride-restrictive fluids improve patient outcomes in acute care.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Comparison of 0.9% saline with Lactated Ringer or Plasmalyte.
  • Analysis of serum chloride levels and acid-base status (e.g., pH, bicarbonate).
  • Assessment of clinical outcomes such as renal injury and mortality.

Main Results:

  • Patients receiving 0.9% saline developed more severe metabolic acidosis.
  • Elevated serum chloride levels were observed in the 0.9% saline group.
  • Balanced crystalloids were associated with reduced acid-base disturbances.
  • Potential improvements in patient outcomes were noted with chloride-restrictive fluids.

Conclusions:

  • 0.9% saline infusions can exacerbate hyperchloremia and acidosis in acute care.
  • Chloride-restrictive intravenous fluids, such as Plasmalyte, appear to mitigate acid-base disturbances.
  • Balanced crystalloids may offer improved patient outcomes compared to 0.9% saline.