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"Fluid resuscitation with large quantities of high chloride containing fluids are shown to increase the incidence of AKI , hyperchloremic normal anion gap metabolic acidosis and mechanical ventilation times,thereby poor outcomes"
fluids for resuscitation in critically ill patients is a controversial topic.Multiple RCT'S have shown harmful effects of hydroxy ethylstarchs.Having said that,fluids are the cornerstone for capillary recruitment in microcirculatory dysfunction syndrome to maintain adequate capillary driving forces .current evidence support crystalloids over colloids for fluid resuscitation in critically ill patients.There is insufficient data or RCT's comparing Normal Saline vs RL (Crystalloids) and also High chloride vs Low chloride containing fluids for resuscitation.Most of these studies are retrospective, prospective or observational with variable quality ,selection bias and some RCT's with small sample size with conflicting results making it more complicated .
"Hunt for Near Ideal Resuscitation Fluid continues...................."
