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Clinical physiology aspects of chloremia in fluid therapy: a systematic review

Clinical physiology aspects of chloremia in fluid therapy: a systematic review

Authors :
David Astapenko
Pavel Navratil
Jiri Pouska
Vladimir Cerny
Source :
Perioperative Medicine, Vol 9, Iss 1, Pp 1-8 (2020)
Publication Year :
2020
Publisher :
BMC, 2020.

Abstract

Abstract Background This systematic review discusses a clinical physiology aspect of chloride in fluid therapy. Crystalloid solutions are one of the most widely used remedies. 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. Methods Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The keywords 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) represents a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chloride homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chloride content on chloremia and organ function.

Details

Language :
English
ISSN :
20470525
Volume :
9
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Perioperative Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.9644de27c90541a5ba51cdf0f8ab79bc
Document Type :
article
Full Text :
https://doi.org/10.1186/s13741-020-00171-3