0.9% saline induced hyperchloremic acidosis

J Trauma Nurs. 2015 Mar-Apr;22(2):111-6. doi: 10.1097/JTN.0000000000000115.

Abstract

In the acute care setting, the type and amount of fluid administered has a significant impact on patient outcomes. In particular, 0.9% saline infusions are known to cause or exacerbate hyperchloremia. The studies presented evaluate possible complications from 0.9% saline infusions. These studies compared administration of 0.9% saline with lactated ringer or plasmalyte in the acute care setting. In each trial, the patients who were randomized to receive 0.9% saline infusions had a more severe acidosis from increased serum chloride levels. From the available data, chloride-restrictive intravenous fluid such as plasmalyte appears to reduce acid-base disturbances and improve patient outcomes.

Publication types

  • Review

MeSH terms

  • Acidosis / chemically induced*
  • Acidosis / prevention & control
  • Critical Care / methods*
  • Electrolytes / administration & dosage
  • Female
  • Fluid Therapy / adverse effects*
  • Fluid Therapy / methods
  • Humans
  • Incidence
  • Isotonic Solutions / administration & dosage
  • Male
  • Primary Prevention / methods
  • Randomized Controlled Trials as Topic
  • Resuscitation / methods
  • Ringer's Lactate
  • Risk Assessment
  • Saline Solution, Hypertonic / administration & dosage
  • Saline Solution, Hypertonic / adverse effects*
  • Sodium Chloride / blood*
  • Treatment Outcome
  • Wounds and Injuries / therapy

Substances

  • Electrolytes
  • Isotonic Solutions
  • Ringer's Lactate
  • Saline Solution, Hypertonic
  • Sodium Chloride
  • Plasmalyte A