Language:

0.9% saline is neither normal nor physiological

Journal of Zhejiang University. B. Science, 2016-03, Vol.17 (3), p.181-187 [Peer Reviewed Journal]

Zhejiang University and Springer-Verlag Berlin Heidelberg 2016 ;Journal of Zhejiang University SCIENCE B is a copyright of Springer, 2016. ;Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2016 2016 ;ISSN: 1673-1581 ;EISSN: 1862-1783 ;DOI: 10.1631/jzus.B1500201 ;PMID: 26984838

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
0.9% saline is neither normal nor physiological
Author: Li, Heng ; Sun, Shi-ren ; Yap, John Q. ; Chen, Jiang-hua ; Qian, Qi
Subjects: Acid-Base Equilibrium ; Acid-base status ; Acidosis ; Acidosis - etiology ; Activation ; Adults ; Alkalosis ; Animals ; Bicarbonate ; Biochemistry ; Biomedical and Life Sciences ; Biomedicine ; Blood ; Blood flow ; Blood transfusion ; Carbonates ; Chlorides - blood ; Complications ; Delivery contracts ; Digestive tract ; Edema ; Education ; Electrolyte balance ; Electrolytes ; Glucose ; Heart diseases ; Hemodynamics ; Humans ; Hyperchloremia ; Hyperkalemia ; Intestine ; Kidney - physiology ; Kidney transplantation ; Kidneys ; Medical personnel ; Metabolic acidosis ; Metabolism ; Morbidity ; Mortality ; Muscle contraction ; Myosin ; Patients ; Phosphorylation ; Physicians ; Physiology ; Review ; Rodents ; Side effects ; Sodium ; Sodium Chloride - adverse effects ; Suction ; Surgery ; Therapy ; Transfusion ; Vomiting
Is Part Of: Journal of Zhejiang University. B. Science, 2016-03, Vol.17 (3), p.181-187
Description: The purpose of this review is to objectively evaluate the biochemical and pathophysiological properties of 0.9% saline (henceforth: saline) and to discuss the impact of saline infusion, specifically on systemic acid-base balance and renal hemodynamics. Studies have shown that electrolyte balance, including effects of saline infusion on serum electrolytes, is often poorly understood among practicing physicians and inappropriate saline prescribing can cause increased morbidity and mortality. Large-volume (>2 L) saline infusion in healthy adults induces hyperchloremia which is associated with metabolic acidosis, hyperkalemia, and negative protein balance. Saline overload (80 ml/kg) in rodents can cause intestinal edema and contractile dysfunction associated with activation of sodium-proton exchanger (NHE) and decrease in myosin light chain phosphorylation. Saline infusion can also adversely affect renal hemodynamics. Microperfusion experiments and real-time imaging studies have demonstrated a reduction in renal perfusion and an expansion in kidney volume, compromising O 2 delivery to the renal parenchyma following saline infusion. Clinically, saline infusion for patients post abdominal and cardiovascular surgery is associated with a greater number of adverse effects including more frequent blood product transfusion and bicarbonate therapy, reduced gastric blood flow, delayed recovery of gut function, impaired cardiac contractility in response to inotropes, prolonged hospital stay, and possibly increased mortality. In critically ill patients, saline infusion, compared to balanced fluid infusions, increases the occurrence of acute kidney injury. In summary, saline is a highly acidic fluid. With the exception of saline infusion for patients with hypochloremic metabolic alkalosis and volume depletion due to vomiting or upper gastrointestinal suction, indiscriminate use, especially for acutely ill patients, may cause unnecessary complications and should be avoided. More education regarding saline-related effects and adequate electrolyte management is needed.
Publisher: Hangzhou: Zhejiang University Press
Language: English
Identifier: ISSN: 1673-1581
EISSN: 1862-1783
DOI: 10.1631/jzus.B1500201
PMID: 26984838
Source: Open Access: PubMed Central
AUTh Library subscriptions: ProQuest Central
MEDLINE

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

0.9% saline is neither normal nor physiological

Zhejiang University and Springer-Verlag Berlin Heidelberg 2016 ;Journal of Zhejiang University SCIENCE B is a copyright of Springer, 2016. ;Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2016 2016 ;ISSN: 1673-1581 ;EISSN: 1862-1783 ;DOI: 10.1631/jzus.B1500201 ;PMID: 26984838

Searching Remote Databases, Please Wait