Key result
Balanced solutions may avoid hyperchloremic acidosis vs 0.9% saline, but clinical morbidity risk remains low.
Why the study?
Excessive use of saline in cardiac surgery can cause hyperchloraemic acidosis, and the morbidity associated with this condition and the potential benefits of balanced solutions remain debated.
Do balanced colloids prevent hyperchloraemic acidosis compared to saline-based solutions in cardiac surgery?
Do balanced colloids prevent hyperchloraemic acidosis compared to saline-based solutions in cardiac surgery?
Balanced solutions and colloids may avoid hyperchloraemic acidosis associated with 0.9% saline, though the clinical morbidity of this condition remains debated.
Answers are grounded in this paper and cite their sources.
May support balanced fluids in select cases; leaves open whether acidosis reduction affects outcomes in randomized trials.
Considerable attention has been given to so-called “balanced solutions” (such as Ringer’s lactate, and more recent derivatives) as alternatives to the less physiological “abnormal” 0.9% saline. Colloids prepared in “balanced” electrolyte solutions have also been developed, alongside similar colloids in saline. This is a consequence of the observation that excessive use of saline will result in hyperchloraemic acidosis, which has been identified as a potential side-effect of saline-based solutions. There is debate about the extent of the morbidity associated with this condition, although the risk is probably quite low. It has been suggested that the use of balanced solutions may avoid this effect.
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A 2011 study conducted a review in Cardiac surgery. Balanced colloids and solutions vs. 0.9% saline was evaluated. Balanced colloids and solutions may avoid hyperchloraemic acidosis compared to 0.9% saline, although the associated morbidity risk is considered low.
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