Intensive Care Medicine

, Volume 42, Issue 12, pp 2046–2048 | Cite as

What’s new on balanced crystalloid solutions?

  • Paul Young
  • Flavia R. Machado
  • Simon Finfer
What's New in Intensive Care

Intravenous fluid therapy is fundamental to the management of acutely ill patients and includes fluid resuscitation to treat hypovolaemia, replacement of ongoing fluid loses, and the provision of maintenance fluids to meet basal requirements for patients unable to drink. A range of crystalloid fluids are available including 0.9 % saline (saline), glucose solutions, and various balanced crystalloids [1]. Saline contains 154 mmol/L of chloride compared with ~100 mmol/L in normal human plasma. While balanced crystalloids have chloride concentrations more closely approximating plasma, they contain anions such as lactate and acetate in non-physiological concentrations.

The infusion of saline has been associated with hyperchloraemic metabolic acidosis and a reduced glomerular filtration rate [2], and its use may result in hypernatraemia. Balanced crystalloids may also have potentially harmful effects. In particular, as all balanced crystalloids are relatively alkaline compared to saline,...


Renal Replacement Therapy Acute Kidney Injury Fluid Resuscitation Metabolic Alkalosis Balance Crystalloid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with ethical standards


The Medical Research Institute of New Zealand receives Independent Research Organisation funding from the Health Research Council of New Zealand. Dr Young reports receiving partial funding for his institution to conduct the Saline vs. Plasma-Lyte 148® for ICU fluid therapy (SPLIT) study. The Plasma-Lyte 148® vs. Saline (PLUS) study is partially funded by Baxter. Professor Finfer declares his employers have received research funding and reimbursement of travel expenses from CSL Behring, Fresenius Kabi and Baxter.

Conflicts of interest

Professor Machado receives research funding from the Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP) and declares no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2016

Authors and Affiliations

  1. 1.Intensive Care UnitWellington Regional Hospital and the Medical Research Institute of New ZealandWellingtonNew Zealand
  2. 2.Anaesthesiology, Pain and Intensive Care DepartmentUniversity of Sao PauloSao PauloBrazil
  3. 3.Division of Critical Care and TraumaThe George Institute for Global Health, and University of SydneySydneyAustralia

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