Is sodium chloride worth its salt?
- PMID: 23759127
- PMCID: PMC3707023
- DOI: 10.1186/cc12732
Is sodium chloride worth its salt?
Abstract
The choice of fluid for resuscitation of the brain-injured patient remains controversial, and the 'ideal' resuscitation fluid has yet to be identified. Large volumes of hypotonic solutions must be avoided because of the risk of cerebral swelling and intracranial hypertension. Traditionally, 0.9% sodium chloride has been used in patients at risk of intracranial hypertension, but there is increasing recognition that 0.9% saline is not without its problems. Roquilly and colleagues show a reduction in the development of hyperchloremic acidosis in brain-injured patients given 'balanced' solutions for maintenance and resuscitation compared with 0.9% sodium chloride. In this commentary, we explore the idea that we should move away from 0.9% sodium chloride in favor of a more 'physiological' solution.
Comment on
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Balanced versus chloride-rich solutions for fluid resuscitation in brain-injured patients: a randomised double-blind pilot study.Crit Care. 2013 Apr 19;17(2):R77. doi: 10.1186/cc12686. Crit Care. 2013. PMID: 23601796 Free PMC article. Clinical Trial.
References
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- Roquilly A, Loutrel O, Cinotti R, Rosenczweig E, Flet L, Mahe PJ, Dumont R, Chupin AM, Peneaux C, Lejus C, Blanloeil Y, Volteau C, Asehnoune K. Balanced versus chloride-rich solutions for fluid resuscitation in brain-injured patients: a randomized double-blind pilot study. Crit Care. 2013;17:R77. doi: 10.1186/cc12686. - DOI - PMC - PubMed
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- Cooper DJ, Myburgh J, Heritier S, Finfer S, Bellomo R, Billot L, Murray L. Vallance The Safe-Tbi Investigators And The Australian And New Zealand Intensive Care Society Clinical Trials Group S. Albumin resuscitation for traumatic brain injury: is intracranial hypertension the cause of increased mortality? J Neurotrauma. 2013;30:512–518. doi: 10.1089/neu.2012.2573. - DOI - PMC - PubMed
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