In their rat hemorrhage model, the authors show that the use of a balanced colloid resuscitation regimen using acetate as a buffer resulted in a better restoration of renal oxygenation than unbalanced colloid or balanced and unbalanced crystalloid solutions. This effect appears to be related to the fact that the latter solutions result in the development of a hyperchloremic metabolic acidosis, which was not observed with the acetate-based (balanced) tetrastarch solution. This interesting experimental observation is consistent with the well-known vasoconstrictive effects of the chloride ion on renal arteriolar vascularization. However, the possible beneficial effect of acetate-based tetrastarch solution on renal oxygenation (and, ultimately, renal function) needs to be confirmed in clinical studies.
– Philippe Van der Linden