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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
SANCHEZ DIAZ, Jesús Salvador et al. Balanced solutions: chlorine the «new villain». Med. crít. (Col. Mex. Med. Crít.) [online]. 2017, vol.31, n.3, pp.152-158. ISSN 2448-8909.
The consequences of resuscitation with liquids are usually minimized and accepted as a «necessary evil», in most cases their origin is iatrogenic. Recently much attention has been paid to balanced solutions which have a quantity of electrolytes more similar to human plasma than other types of solutions. The objective of this review is to know the pathophysiological aspects and current evidence regarding the use of balanced solutions in critically ill patients. Highlight the deleterious effects of hyperchloremia and its association with poor results. To understand how balanced solutions work we must know the Stewart Model for acid-base alterations. The interest in hyperchloremia is due to the fact that the administration of solutions is the most common maneuver in acute medicine and in turn the saline solution 0.9% the liquid mostly administered. The saline solution 0.9% can become a «problem» and not a «solution» if we do not select the right patient. Balanced solutions are an option, but not a solution in different populations of critically ill patients.
Palabras llave : Balanced solutions; critically ill patients; hyperchloremia; Stewart model.