REVIEW – October 2019

Crystalloid solutions in infusion therapy

Authors: Minna Mari Lett, Joel Starkopf

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Abstract

The Indian Blue Cholera pandemic in 1831 stimulated the first developments in intravenous fluid therapy by the two pioneers Thomas Latta and William O’Shaughnessy. Nowadays crystalloid solutions are the most widely used i.v. solutions and are administered at some point during treatment to almost all acutely ill patients. Each type of i.v. fluid has some certain advantages compared with other fluids but also some shortcomings. The most widely used i.v. crystalloid solutions differ considerably from human plasma in composition, tonicity, or both. The most frequently prescribed crystalloid solutions are normal saline and Ringer’s lactate solutions. Possible disadvantages of 0.9% NaCl solution are hypercholeremic acidosis, negative effect on renal function and changes in potassium levels. Using balanced solutions like Ringer`s lactate results in more stable pH. The 0.9% NaCl is better for neurosurgical patients because balanced solutions are relatively
hypotonic and may cause a rise in intracranial pressure. The 0.9% NaCl solution is also better for patients who have alkalosis or hypochloremia. When Ringer’s lactate is more linked to hypercoagulation then normal saline, on the other hand, can cause dilution coagulopathy.