Hyperchloraemia and Acidosis
Jul 31, 2008 in Learn
Well, the great fluid debate continues to rage as ever, including the colloid/crystalloid argument, but more importantly there has just recently been an explosion of interest in balanced fluid solutions.
According to a review article in the August edition of the BJA (2008) there are probably several reasons for this:
- Renewed interest in Stewart’s hypothesis in assessing acid-base balance.
- Recognition of the fact that “normal” saline causes hyperchloraemic acidosis,
- And the arrival of new balanced salt solutions.
Braun AND Fresenius Kabi have recently had hydroxy-ethyl-starch solutions in balanced solutions (i.e. things similar to Hartmann’s) approved in the EU.
Acidosis has long been known to cause all kinds of problems, although there are examples of physiological acidosis (such as in exercise) which confer advantage.
We believe that there is a possibility that in light of an NPSA publication about paediatric fluid administration and the fact that these fluids have been licensed, followed by a review article in the BJA, a question on fluid use and possibly on how it can affect acidosis is a possibility.
There are several resources on the internet about acidosis and the Stewart hypothesis:
