Chasing the base deficit: hyperchloraemic acidosis following 0.9% saline fluid resuscitation

Citation
S. Skellett et al., Chasing the base deficit: hyperchloraemic acidosis following 0.9% saline fluid resuscitation, ARCH DIS CH, 83(6), 2000, pp. 514-516
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
ARCHIVES OF DISEASE IN CHILDHOOD
ISSN journal
0003-9888 → ACNP
Volume
83
Issue
6
Year of publication
2000
Pages
514 - 516
Database
ISI
SICI code
0003-9888(200012)83:6<514:CTBDHA>2.0.ZU;2-Z
Abstract
Base deficit is a parameter often used to guide further treatment in acidot ic children and is taken as a measure of how "sick" they are. Five children with septic shock are presented who had persisting base deficit after larg e volume resuscitation with 0.9% saline. Stewart's strong ion theory of aci d-base balance is able to quantify the causes of metabolic acidosis and is used to show that our patients had a hyperchloraemic metabolic acidosis. We show how the chloride content of the saline loads given to our patients ca used this hyperchloraemia. It is concluded that 0.9% saline and other chlor ide rich fluids may not be ideal resuscitation fluids; if used, clinicians must be aware of their potential to cause a persistent base deficit.