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Assessment of Motor Balance and Coordination in Mice using the Balance Beam
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Balanced Crystalloid Solutions.

Matthew W Semler1, John A Kellum2

  • 11 Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and.

American Journal of Respiratory and Critical Care Medicine
|November 9, 2018
PubMed
Summary
This summary is machine-generated.

Balanced crystalloids are a safer alternative to saline for intravenous fluid therapy in critically ill patients. Evidence suggests saline may cause adverse effects, while balanced fluids reduce complications like acute kidney injury.

Keywords:
acute kidney injurybalanced crystalloidscritical illnessintravenous fluidsaline

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Emergency Medicine

Background:

  • Intravenous fluid therapy is a cornerstone of critical care.
  • Saline (0.9% sodium chloride) has been the traditional fluid of choice.
  • Balanced crystalloids offer an alternative with a composition closer to extracellular fluid.

Purpose of the Study:

  • To review the evidence comparing saline with balanced crystalloids in acutely ill patients.
  • To assess the impact of fluid choice on acid-base balance and clinical outcomes.
  • To identify knowledge gaps in intravenous fluid therapy research.

Main Methods:

  • Review of preclinical research, patient studies, and randomized trials.
  • Analysis of observational studies in critically ill adults.
  • Examination of recent large randomized trials comparing fluid types.

Main Results:

  • Saline may cause hyperchloremic metabolic acidosis, inflammation, hypotension, and acute kidney injury.
  • Balanced crystalloids prevent acidosis and may reduce vasopressor use in surgical patients.
  • Observational data links balanced crystalloids to lower rates of acute kidney injury and death in critically ill adults.

Conclusions:

  • Growing evidence raises concerns about using saline as the primary crystalloid in critically ill adults.
  • Balanced crystalloids appear to be associated with improved patient outcomes.
  • Further research is needed to fully elucidate optimal fluid therapy strategies in critical illness.