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A brief history of crystalloids: the origin of the controversy

Fluid resuscitation with crystalloids has been used in humans for more than 100 years. In patients with trauma, sepsis or shock of any etiology, they can help modify the clinical course of the illness. However, these solutions are medications which are not side-effect free. Recently, they have been...

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Autores principales: Fernández-Sarmiento, Jaime, Casas-Certain, Carolina, Ferro-Jackaman, Sarah, Solano-Vargas, Fabian H., Domínguez-Rojas, Jesús Ángel, Pilar-Orive, Francisco Javier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351043/
https://www.ncbi.nlm.nih.gov/pubmed/37465421
http://dx.doi.org/10.3389/fped.2023.1202805
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author Fernández-Sarmiento, Jaime
Casas-Certain, Carolina
Ferro-Jackaman, Sarah
Solano-Vargas, Fabian H.
Domínguez-Rojas, Jesús Ángel
Pilar-Orive, Francisco Javier
author_facet Fernández-Sarmiento, Jaime
Casas-Certain, Carolina
Ferro-Jackaman, Sarah
Solano-Vargas, Fabian H.
Domínguez-Rojas, Jesús Ángel
Pilar-Orive, Francisco Javier
author_sort Fernández-Sarmiento, Jaime
collection PubMed
description Fluid resuscitation with crystalloids has been used in humans for more than 100 years. In patients with trauma, sepsis or shock of any etiology, they can help modify the clinical course of the illness. However, these solutions are medications which are not side-effect free. Recently, they have been questioned in terms of quantity (fluid overload) and their composition. The most frequently used crystalloids, both in high and low-income countries, are 0.9% normal saline (NS) and Ringer's lactate. The first descriptions of the use of sodium and water solutions in humans date from the cholera epidemic which spread throughout Europe in 1831. The composition of the fluids used by medical pioneers at that time differs greatly from the 0.9% NS used routinely today. The term “physiological solution” referred to fluids which did not cause red blood cell hemolysis in amphibians in in vitro studies years later. 0.9% NS has an acid pH, a more than 40% higher chloride concentration than plasma and a strong ion difference of zero, leading many researchers to consider it an unbalanced solution. In many observational studies and clinical trials, this 0.9% NS composition has been associated with multiple microcirculation and immune response complications, acute kidney injury, and worse clinical outcomes. Ringer’s lactate has less sodium than plasma, as well as other electrolytes which can cause problems in patients with traumatic brain injury. This review provides a brief summary of the most important historical aspects of the origin of the most frequently used intravenous crystalloids today.
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spelling pubmed-103510432023-07-18 A brief history of crystalloids: the origin of the controversy Fernández-Sarmiento, Jaime Casas-Certain, Carolina Ferro-Jackaman, Sarah Solano-Vargas, Fabian H. Domínguez-Rojas, Jesús Ángel Pilar-Orive, Francisco Javier Front Pediatr Pediatrics Fluid resuscitation with crystalloids has been used in humans for more than 100 years. In patients with trauma, sepsis or shock of any etiology, they can help modify the clinical course of the illness. However, these solutions are medications which are not side-effect free. Recently, they have been questioned in terms of quantity (fluid overload) and their composition. The most frequently used crystalloids, both in high and low-income countries, are 0.9% normal saline (NS) and Ringer's lactate. The first descriptions of the use of sodium and water solutions in humans date from the cholera epidemic which spread throughout Europe in 1831. The composition of the fluids used by medical pioneers at that time differs greatly from the 0.9% NS used routinely today. The term “physiological solution” referred to fluids which did not cause red blood cell hemolysis in amphibians in in vitro studies years later. 0.9% NS has an acid pH, a more than 40% higher chloride concentration than plasma and a strong ion difference of zero, leading many researchers to consider it an unbalanced solution. In many observational studies and clinical trials, this 0.9% NS composition has been associated with multiple microcirculation and immune response complications, acute kidney injury, and worse clinical outcomes. Ringer’s lactate has less sodium than plasma, as well as other electrolytes which can cause problems in patients with traumatic brain injury. This review provides a brief summary of the most important historical aspects of the origin of the most frequently used intravenous crystalloids today. Frontiers Media S.A. 2023-07-03 /pmc/articles/PMC10351043/ /pubmed/37465421 http://dx.doi.org/10.3389/fped.2023.1202805 Text en © 2023 Fernández-Sarmiento, Casas-Certain, Ferro-Jackaman, Solano-Vargas, Domínguez-Rojas and Pilar-Orive. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Fernández-Sarmiento, Jaime
Casas-Certain, Carolina
Ferro-Jackaman, Sarah
Solano-Vargas, Fabian H.
Domínguez-Rojas, Jesús Ángel
Pilar-Orive, Francisco Javier
A brief history of crystalloids: the origin of the controversy
title A brief history of crystalloids: the origin of the controversy
title_full A brief history of crystalloids: the origin of the controversy
title_fullStr A brief history of crystalloids: the origin of the controversy
title_full_unstemmed A brief history of crystalloids: the origin of the controversy
title_short A brief history of crystalloids: the origin of the controversy
title_sort brief history of crystalloids: the origin of the controversy
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351043/
https://www.ncbi.nlm.nih.gov/pubmed/37465421
http://dx.doi.org/10.3389/fped.2023.1202805
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