Balanced vs unbalanced fluid resuscitation

Abstract

Background. There is a controversy regarding type of fluid resuscitation (balanced or unbalanced). While resuscitation with chloride rich fluids (e.g. sodium chloride) seems to be responsible for the metabolic hyperchloremic acidosis development, the clinical relevance of the latter is not clear. the objectives of this study were to assess metabolic acidosis occurrence and its clinical relevance in view of balanced versus unbalanced (saline based) fluid resuscitation. Methods. This is a systematic review and metaanalysis of prospectively designed studies and abstracts published from 1955 to 29 June 2011. The primary endpointd were metabolic acidosis and hyperchloremia development following fluid resuscitation. The secondary endpoints included blood loss, blood product transfusion, renal function defined by the urinary output, creatinine level and creatinine clearance and use of catecholamines, lenght of hospital stay and mortality. [...].