0.9% Saline or Hartmann’s?

I had nothing else better to do so I went googling. These are a few interesting facts that might come in handy one day.

As we all know, 0.9% saline (normal saline) is a widely accepted choice for fluid resuscitation in most of the situations. Eg. hypovolaemic shock, septic shock, burns, etc etc.

However, nothing is perfect and there is a downside to it. When it is used especially in huge amounts during emergency resuscitation, it may sometimes cause hyperchloraemic metabolic acidosis.

So what is hyperchloraemic metabolic acidosis?

It’s pretty much the same as the usual metabolic acidosis except that it has a normal anion gap.

If you want more information about it, just go here. AnaesthesiaMCQ.com. It has better explanations.

Acidosis can happen because of shock. Tissue perfusion decreases. There is hypoxaemia. Lactic acidosis occurs. However, heavy administration of 0.9% saline may cause acidosis as well. So it’s an “either or” situation. So be careful not to get too indulged in resuscitating the patient without thinking what you’re giving. You may be the cause of the acidosis itself.

Hartmann’s solution is the best next choice.

At the end of the day, what fluid to use is entirely up to you. Just keep in mind that there’s a risk of acidosis when using 0.9% saline alone.

A mixture of both solution sounds pretty alright to me… no?

Fluid Therapy for the Needy