a reduced glomerular filtration rate . 7 Utilising a more physiologically balanced intravenous fluid regimen appropriate to the individual ’ s biochemistry and fluid balance can reduce the sodium and chloride load . A meta-analysis demonstrated that , compared with hydroxyethyl starches , patients who received crystalloids or albumin were less likely to require renal replacement therapies and transfusion with red blood cells and experienced fewer overall adverse events . 8
Range of formulations and volumes A range of different crystalloid solutions are available , mainly containing sodium chloride and / or dextrose in a range of different concentrations , the most commonly used solutions being detailed in Table 1 .
Hartmann ’ s and Ringer ’ s lactate solutions are also available , both of which contain lactate as a bicarbonate precursor . These were developed to be more similar to plasma in their composition . Some solutions are also available with additional
If large volumes of crystalloids with high chloride content , particularly sodium chloride 0.9 %, are given in an attempt to restore the circulating volume , there is a risk of hypochloraemic acidosis potassium , so that maintenance or replacement of potassium can also be achieved via the one infusion . Most solutions are also available in a range of different volumes , according to individual patient fluid requirements .
Wide compatibility Most crystalloid solutions are compatible with a range of intravenous drugs and sodium chloride 0.9 % and dextrose 5 % are often used as diluents and carrier solutions for their administration . Individual compatibility details should always be confirmed before administration . However , it is not recommended to administer blood products via the same intravenous line as Hartmann ’ s or dextrose 5 % due to concerns over clotting and haemolysis . 9
No religious / moral objections to use As crystalloids are not derived from either human or animal sources , there are no religious or moral objections associated with their use .
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