The Myth of 0.9% Saline

Abstract

Normal saline is the crystalloid of choice for fluid resuscitation with its utility born out of the cholera epidemic of 1832. However, its ubiquitous usage is being challenged because of a growing body of evidence suggesting that a large volume infusion of normal saline does in fact have deleterious effects on multiple body systems. Careful considerations should be given to the physiological effects of using large amounts of normal saline as one would with another pharmacological agents.

Quantitative Investigation into the influence of intravenous fluids on human immune and cancer cell lines

“…Since NaCl diluent makes the medium hypertonic 36 , it supports viability assays resulting in a decrease of cell counts, excluding MCF7 cells. Our results demonstrated that NaCl significantly decreased viability of U937 monocytes, macrophages and According to intensive care units, despite NaCl and dextrose being the main crystalloid fluid for revival, the utilization of lactated Ringer has been increased recently 7,31,32 . Dr. Brown and co-worker's discussion about the outcomes of the medication diluent recommended balanced crystalloids such as lactated Ringer solution due to their chemical composition that is safe for a patient's acid-base status and organ function 37,38 .…”

“…According to intensive care units, despite NaCl and dextrose being the main crystalloid fluid for revival, the utilization of lactated Ringer has been increased recently 7 , 31 , 32 . Dr. Brown and co-worker’s discussion about the outcomes of the medication diluent recommended balanced crystalloids such as lactated Ringer solution due to their chemical composition that is safe for a patient’s acid-base status and organ function 37 , 38 .…”

“…However, still most of the recent discussions focus on investigating large clinical trials to better define optimal fluid therapy in acute and critical care medicine [30][31][32][33][34] .…”