Anaes Cases · Perioperative fluid & goal-directed therapy
Saline-induced hyperchloraemic acidosis
Short case — saline-induced hyperchloraemic metabolic acidosis. High chloride (154 mmol/L); strong-ion-difference reduction; renal vasoconstriction; AKI risk. Balanced crystalloid preferred; avoid large-volume saline.
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ANZCAFRCAABAEDAIC
Prompt
A patient received 3 L of 0.9 per cent saline intraoperatively. Postoperative blood gas shows pH 7.28, chloride 118 mmol/L, base excess minus 7. Explain and advise.
Presentation
A patient received 3 L of 0.9 per cent saline during open abdominal surgery. Postoperative blood gas: pH 7.28, chloride 118 mmol/L, base excess minus 7, bicarbonate 18. Kidney function normal. Explain and advise.[40823585]
References2ShowHide
- [1]Lorente JV, et al. Perioperative fluid therapy: a narrative review. Front Med, 2025.PMID 40823584
- [40823585]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.