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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

Rapid IJ (aka Easy Internal Jugular Cannulation)

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lunes, 18 de febrero de 2013

Suero fisiológico: tóxico renal?

 
"Does Normal Saline Cause Acute Renal Failure?
To internal medicine-trained physicians in the U.S., normal saline solution seems as harmless and healthy as mother’s milk. Intensivists trained in anesthesia or surgery might more often mention normal saline’s hypertonicitycompared to blood, and its propensity to cause hyperchloremia, compared to lactated Ringer’s or similar solutions. But who cares, really? Chloride is that number you can usually ignore in the chemistry panel — almost always clinically irrelevant. Right?
Evidence suggests that in fact, excess chloride may be a little nastier than previously suspected. Normal saline infusion may worsen kidney perfusion, compared to PlasmaLyte, a crystalloid concoction that approximates human plasma in pH, osmolality, buffering capacity, etc. Normal saline also causes hyperchloremic metabolic acidosis, although any ill effects of that aren’t clear."