Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: A balanced view of balanced solutions. | Guidet et al. Critical Care 2010 14 325 http content 14 5 325 CRITICAL CARE VIEWPOINT L_ A balanced view of balanced solutions Bertrand Guidet1 2 3 Neil Soni4 5 Giorgio Della Rocca6 Sibylle Kozek7 Benoit Vallet8 Djillali Annane9 and Mike James10 Abstract The present review of fluid therapy studies using balanced solutions versus isotonic saline fluids both crystalloids and colloids aims to address recent controversy in this topic. The change to the acid-base equilibrium based on fluid selection is described. Key terms such as dilutional-hyperchloraemic acidosis correctly used instead of dilutional acidosis or hyperchloraemic metabolic acidosis to account for both the Henderson-Hasselbalch and Stewart equations isotonic saline and balanced solutions are defined. The review concludes that dilutional-hyperchloraemic acidosis is a side effect mainly observed after the administration of large volumes of isotonic saline as a crystalloid. Its effect is moderate and relatively transient and is minimised by limiting crystalloid administration through the use of colloids in any carrier . Convincing evidence for clinically relevant adverse effects of dilutional-hyperchloraemic acidosis on renal function coagulation blood loss the need for transfusion gastrointestinal function or mortality cannot be found. In view of the longterm use of isotonic saline either as a crystalloid or as a colloid carrier the paucity of data documenting detrimental effects of dilutional-hyperchloraemic acidosis and the limited published information on the effects of balanced solutions on outcome we cannot currently recommend changing fluid therapy to the use of a balanced colloid preparation. Introduction Normal saline solution has been used for over 50 years in a multitude of clinical situations as an intraoperative resuscitation and maintenance fluid therapy. Neither normal nor physiological however saline solution is still a standard against which other solutions are .
