Photo Credit: Eugene Nekrasov
The following is a summary of “Effect of a single small volume fluid bolus with balanced or un-balanced fluids on chloride and acid–base status: a prospective randomized pilot study (the FLURES-trial),” published in the March 2024 issue of Nephrology by Raes et al.
Researchers conducted a prospective study comparing short-term effects on acid-base, electrolyte status, and urine output of a single fluid bolus of saline to that of balanced solution Plasmalyte® in critically ill patients.
They conducted a randomized controlled trial on adult patients receiving a fluid bolus. They were divided into two groups, one receiving saline (NaCl 0.9%) and the other Plasmalyte®. Blood and urine samples were collected at four intervals to analyze the effects of fluid boluses on serum chloride, base excess, apparent strong ion difference, urinary output, and blood pressure.
The results demonstrated that 1 L saline bolus showed significant serum chloride increase (1.60; 95% CI 1.10 to 2.10; P < 0.001) and short-term declines in apparent strong ion difference (−1.85; 95% CI −2.71 to −0.99; P < 0.001) and base excess (−0.90; 95% CI −1.31 to −0.50; P < 0.001). Hyperchloremia incidence rose by 17% (0.17; 95% CI 0.05 to 0.29; P = 0.005) in the saline group. No differences between groups were observed in urinary output, blood pressure, or vasopressor requirement.
Investigators concluded that a small, single dose of saline significantly increases chloride concentration and decreases apparent strong ion difference and base excess, along with increasing the number of patients developing hyperchloremia.
Source: link.springer.com/article/10.1007/s40620-024-01912-z