Is There a Role for Balanced Solutions in Septic Patients?

Area of Science:

• Critical Care Medicine
• Nephrology
• Intensive Care

Background:

• Fluid bolus infusion is crucial for hemodynamic resuscitation in critically ill patients.
• Colloid use has declined due to trials suggesting no benefit and potential harm.
• Traditional saline solutions are high in chloride, linked to metabolic acidosis and renal issues.

Purpose of the Study:

• To review the literature on the clinical and laboratorial benefits of balanced solutions.
• To compare balanced solutions with traditional saline in septic patients.

Main Methods:

• Literature review of clinical trials and observational studies.
• Focus on balanced solutions versus normal saline in critically ill and septic patients.

Main Results:

• Balanced solutions, with lower chloride concentrations, show potential physiological benefits.
• High chloride in normal saline is associated with metabolic acidosis, renal vasoconstriction, and reduced urine output.
• Acute kidney injury was not observed with saline in prospective randomized controlled trials.

Conclusions:

• Balanced solutions represent a promising alternative to traditional saline for fluid resuscitation.
• Further research is warranted to confirm the benefits of balanced solutions in septic patients.