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Erschienen in: Wiener klinische Wochenschrift 7-8/2018

02.03.2018 | review article

Crystalloid fluid choice in the critically ill

Current knowledge and critical appraisal

verfasst von: Carmen A. Pfortmueller, MD, Barbara Kabon, MD, Joerg C. Schefold, MD, Edith Fleischmann, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 7-8/2018

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Summary

Intravenous infusion of crystalloid solutions is one of the most frequently administered medications worldwide. Available crystalloid infusion solutions have a variety of compositions and have a major impact on body systems; however, administration of crystalloid fluids currently follows a “one fluid for all” approach than a patient-centered fluid prescription. Normal saline is associated with hyperchloremic metabolic acidosis, increased rates of acute kidney injury, increased hemodynamic instability and potentially mortality. Regarding balanced infusates, evidence remains less clear since most studies compared normal saline to buffered infusion solutes.; however, buffered solutes are not homogeneous. The term “buffered solutes” only refers to the concept of acid-buffering in infusion fluids but this does not necessarily imply that the solutes have similar physiological impacts. The currently available data indicate that balanced infusates might have some advantages; however, evidence still is inconclusive. Taking the available evidence together, there is no single fluid that is superior for all patients and settings, because all currently available infusates have distinct differences, advantages and disadvantages; therefore, it seems inevitable to abandon the “one fluid for all” strategy towards a more differentiated and patient-centered approach to fluid therapy in the critically ill.
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Metadaten
Titel
Crystalloid fluid choice in the critically ill
Current knowledge and critical appraisal
verfasst von
Carmen A. Pfortmueller, MD
Barbara Kabon, MD
Joerg C. Schefold, MD
Edith Fleischmann, MD
Publikationsdatum
02.03.2018
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 7-8/2018
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-018-1327-y

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