Abstract
Background: Crystalloid solutions are one of the most widely used remedies in the field. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates. Current balanced solutions are safer in this respect and are designed to have a composition close to that of blood plasma.Methods: Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The key words searched for included hyperchloremia, hypochloremia and compound words containing the word “chloride”, infusion therapy, metabolic acidosis, renal failure, and review.Results: A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed.Conclusions: According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) is a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chlorine homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chlorine content on chloremia and organ function.
PSU6 Economic Evaluation of Acetate-Buffered Crystalloid Solutions for Infusion Therapy during the Abdominal Surgery in Russia
