Influence of goal-directed therapy with balanced crystalloid-colloid or unbalanced crystalloid solution on base excess.

Krebbel H, Feldheiser A, Muller O, et al.
J Int Med Res 2014;42:468-486.
NATA Rating :
Review by : S. Kozek-Langenecker
NATA Review

The authors showed similar fluid requirements with 3% tetrastarch (in balanced solvent) and unbalanced crystalloid in 40 patients undergoing a standardised surgical procedure, primary hip replacement, with only moderate bleeding. Plasma chloride concentration was higher in patients exposed to the unbalanced solution resulting in a lower standard base excess. Together, these findings are in line with existing understanding of context-sensitive volume efficacy of 3% tetrastarch and the induction of hyperchloraemic metabolic acidosis by unbalanced salt infusion.

– Sibylle Kozek-Langenecker

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