Fluids, pH, ions and electrolytes

Curr Opin Crit Care. 2010 Aug;16(4):323-31. doi: 10.1097/MCC.0b013e32833c0957.


Purpose of review: Significant attention has been recently focused on both maintenance fluid and resuscitation fluid use in critical care. Accordingly, a focused review of the properties of crystalloid and colloid fluids, their expected benefits, and potential deleterious side effects is appropriate and timely.

Recent findings: Despite their ubiquitous use, well described side effects, and ability to be titrated to a physiologic endpoint, fluids are rarely considered in a fashion similar to other pharmacologic agents. Understanding their physical and chemical properties allows the clinician to understand, anticipate and deliberately harness their expected impact on acid-base balance. Expanded insights into the pathogenesis of common acid-base disorders may be gleaned from utilizing a physicochemical approach that allows the precise quantification of the ionic species that impact pH.

Summary: This focused review further enables the clinician to appropriately investigate, modify, and optimize bedside clinical care related to fluid and acid-base management.

Publication types

  • Review

MeSH terms

  • Acidosis
  • Albumins
  • Amylopectin
  • Chemical Phenomena
  • Chlorides
  • Colloids*
  • Crystalloid Solutions
  • Dextrans / administration & dosage
  • Dextrans / chemistry
  • Dextrans / therapeutic use
  • Electrolytes / chemistry*
  • Fluid Therapy*
  • Humans
  • Hydrogen-Ion Concentration
  • Hypernatremia / prevention & control
  • Hypokalemia / prevention & control
  • Hyponatremia / prevention & control
  • Isotonic Solutions / therapeutic use*
  • Osmolar Concentration
  • Potassium
  • Resuscitation
  • Sodium


  • Albumins
  • Chlorides
  • Colloids
  • Crystalloid Solutions
  • Dextrans
  • Electrolytes
  • Isotonic Solutions
  • Amylopectin
  • Sodium
  • Potassium