Hyperchloraemic acidosis: another misnomer?

A balanced view of balanced solutions

The present review of fluid therapy studies using balanced solutions versus isotonic saline fluids (both crystalloids and colloids) aims to address recent controversy in this topic. The change to the acid-base equilibrium based on fluid selection is described. Key terms such as dilutional-hyperchloraemic acidosis (correctly used instead of dilutional acidosis or hyperchloraemic metabolic acidos...

Diabetic ketoacidosis and prolonged hyperchloraemic acidosis in a patient treated with risperidone

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes. The development of metabolic syndrome is widely recognised with the use of atypical antipsychotic agents, and not infrequently DKA has been described with some of these drugs. We describe a complex patient with HIV who presented with severe DKA and prolonged hyperchloraemic acidosis, which we postulate was associated wi...

The role of the colon in the pathogenesis of hyperchloraemic acidosis in ureterosigmoid anastomosis.

Balanced versus chloride-rich solutions for fluid resuscitation in brain-injured patients: a randomised double-blind pilot study

INTRODUCTION We sought to investigate whether the use of balanced solutions reduces the incidence of hyperchloraemic acidosis without increasing the risk for intracranial hypertension in patients with severe brain injury. METHODS We conducted a single-centre, two-arm, randomised, double-blind, pilot controlled trial in Nantes, France. Patients with severe traumatic brain injury (Glasgow Coma ...

Metabolic acidosis: neo-considerations for general surgeons

Hyperchloraemic metabolic acidosis is a documented complication of neobladder formation. However, it usually improves with time and is mild. Severe and persistent metabolic acidosis may manifest when patients undergo further surgery for other reasons. Neobladder formation following radical cystectomy or cystoprostatectomy is becoming increasingly common, and surgeons treating patients with neo...