Hyperchloremic acidosis during plasma expansion: FLUIDS AND HYPERCHLOREMIC ACIDOSIS

SUMMARY Many crystalloid and colloid plasma expanders can induce ‘hyperchloremic’ metabolic acidosis. This finding, first reported over 50 years ago, has received renewed interest following the recent availability of ‘balanced’ solutions. Several questions must be addressed and answered before making recommendations with regard to the use of these solutions. Do acidosis and hyperchloremia always go hand in hand? What is the clinical impact of hyperchloremic acidosis? Are all ‘balanced’ plasma expanders equivalent? Should isotonic saline-based plasma expanders be abandoned? Several elements of reflection are summarized in this brief review. On the basis on the currently available literature, it is not objectively possible to propose clear-cut guidelines.