Date of Presentation
5-4-2023 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Normal saline and balanced crystalloids, such as lactated Ringer's (LR) and Plasma-Lyte A, are commonly used in the emergency setting for fluid resuscitation. However, there has been growing interest in recent years in whether balanced crystalloids may be superior to normal saline, particularly in critically ill patients.
Normal saline has been the traditional fluid of choice for decades due to its widespread availability, low cost, and presumed safety. However, normal saline has a high chloride concentration (154 mmol/L), which can lead to hyperchloremic metabolic acidosis and other adverse effects, such as renal vasoconstriction and reduced renal blood flow.
In contrast, balanced crystalloids have a more physiologic electrolyte composition, with lower chloride and higher bicarbonate levels, and may therefore be associated with better acid-base balance, renal function, and other outcomes. Several large randomized controlled trials (RCTs) have compared the use of balanced crystalloids to normal saline in various patient populations, including sepsis, major surgery, and critically ill patients in the emergency department.
According to severe ill patients, we will answer the following questions in this literature review. How does Normal saline vs Balanced cystalloids (LR or plasma-lyte) affect mortality? Which fluid selection does better in the setting of AKI? Which fluids is better in the setting of lactic acidosis?
Keywords
Intravenous Infusions, Saline Solution, Rehydration Solutions, Patient Care, Acute Kidney Injury, Lactic Acidosis
Disciplines
Critical Care | Emergency Medicine | Equipment and Supplies | Health and Medical Administration | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms | Pharmaceutical Preparations
Document Type
Poster
Included in
Critical Care Commons, Emergency Medicine Commons, Equipment and Supplies Commons, Health and Medical Administration Commons, Pathological Conditions, Signs and Symptoms Commons, Pharmaceutical Preparations Commons
Brief Review: IV Fluid Choice in the Emergency Department
Normal saline and balanced crystalloids, such as lactated Ringer's (LR) and Plasma-Lyte A, are commonly used in the emergency setting for fluid resuscitation. However, there has been growing interest in recent years in whether balanced crystalloids may be superior to normal saline, particularly in critically ill patients.
Normal saline has been the traditional fluid of choice for decades due to its widespread availability, low cost, and presumed safety. However, normal saline has a high chloride concentration (154 mmol/L), which can lead to hyperchloremic metabolic acidosis and other adverse effects, such as renal vasoconstriction and reduced renal blood flow.
In contrast, balanced crystalloids have a more physiologic electrolyte composition, with lower chloride and higher bicarbonate levels, and may therefore be associated with better acid-base balance, renal function, and other outcomes. Several large randomized controlled trials (RCTs) have compared the use of balanced crystalloids to normal saline in various patient populations, including sepsis, major surgery, and critically ill patients in the emergency department.
According to severe ill patients, we will answer the following questions in this literature review. How does Normal saline vs Balanced cystalloids (LR or plasma-lyte) affect mortality? Which fluid selection does better in the setting of AKI? Which fluids is better in the setting of lactic acidosis?