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A recent review identified 5 key points to consider when prescribing fluids.
- Fluids should be prescribed as drugs, recognizing that any fluid can be harmful if dosed incorrectly.
- The differences in efficacy between administering a 'crystalloid versus colloid' are modest; however, the cumulative differences in safety appear more significant.
- The qualitative toxicity associated with hydroxyethyl starch (HES) and isotonic saline remains a concern.
- The differences in chloride load and strong ion difference between cystalloid solutions, such as isotonic saline compared with physiologically more balanced solutions, appear to have clinical relevance.
- The 'default' resuscitation fluid for acutely ill patients should likely be physiologically balanced crystalloid solutions (eg, PlasmaLyte or Ringer's lactate ).
References
Raghunathan K, et al. Fluids are drugs: type, dose and toxicity. Curr Opin Crit Care 2013;19(4):290-8. [PMID 23817025]
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