Hyperchloremia After Noncardiac Surgery Is Independently Associated with Increased Morbidity and Mortality

Abstract

This retrospective cohort trial demonstrates an association between hyperchloremia and poor postoperative outcome. Additional studies are required to demonstrate a causal relationship between these variables.

Principles of Fluid Management

“…[39][40][41][42][43][44][45] Consistent with experimental and small human clinical studies, use of crystalloid solutions with lower chloride content were found to be beneficial. [46][47][48] Saline (0.9%) solution is nonphysiologic, and the high chloride concentration and lower SID compared with plasma (0.9% saline, SID 0 mmol/L vs Plasma, SID 40 mmol/L) directly incites an iatrogenic hyperchloremic metabolic acidosis, which may mask, simulate, and/or precipitate to occurrence of significant adverse effects.…”

Fluid Management in Abdominal Surgery

“…[4][5][6][7] Elevated serum chloride concentrations have been associated with renal vasoconstriction and renal parenchymal swelling in animal studies 8,9 and an increase in postoperative 30-day mortality in large database analyses. 10 The deleterious effects of administration of large volumes of 0.9% saline on the kidney have also been shown in a human study that demonstrated decreased renal blood flow velocity and cortical tissue perfusion. 11 Acknowledging potential clinical implications, the British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients recommended the use of balanced crystalloids rather than isotonic saline in most routine clinical settings.…”

Comparative analysis of fluid therapy in coronary artery bypass grafting surgery

“…Инфузионную терапию для обеспечения потребности в жидкости во всех груп-пах выполняли сбалансированным солевым раство-ром, в то время как необходимость в устранении дефи-цита объема внутрисосудистой жидкости обеспечивали одним из представленных растворов: сбалансиро-ванным солевым, 4% модифицированным желатином или 6% ГЭК 130/0,42. Использование указанных рас-творов обусловлено тем, что они имеют более высо-кий профиль безопасности в сравнении с другими рас-творами у пациентов хирургического профиля [10,11].…”