Table 3.
Measured change in serum chloride from 1- and 2-liter infusions of various crystalloid fluids
| Infusion Volume and Duration | Mean Change in Serum [Cl−], mEq/l | Comments, [Cl−] in mEq/l |
|---|---|---|
| Normal saline | ||
| 1 liter over 1 h (115) | 104 to 107.5 in the 1st hour followed by a gradual decrease of 1 over the next 6 h | • Gradually decreased by 1 over the next 6 h |
| 2 liters over 1 h (172) | 103.0 to ~107.5 in the 1st hour | • Gradually decreased to 106 over the next 5 h |
| 2 liters over 1 h (116) | 103 to 108 in the 1st hour | • Gradually decreased to 106 over the next 5 h |
| 2 liters over 1 h (31) | 103 to 108.5 in the 1st hour | • Gradually decreased to 106 over the next 3 h |
| 2 liters over 25 min (40) | Peaked at 108.3 within the 1st 2.5 h postinfusion compared with 104.1 in control subjects, who did not receive any infusion | • Serum chloride remained elevated around 105 for up to 22 h postinfusion |
| • Serum renin and aldosterone concentrations were significantly reduced for 2 days postinfusion | ||
| Median fluid volume administration of 1 liter (195) | 103.1 to ~105.5 during slightly less than the 1st 24 h from ED arrival | • 6,639 SALT-ED trial participants |
| Hartmann’s solution | ||
| 2 liters over 1 h (172) | 102.5 to 104.5 | • Cl remained around 104.5 for the next 3 h then decreased to around 103.5 for the next 2 h |
| • Hartmann’s solution induced 1.7 times greater natriuresis compared with normal saline despite the lower sodium concentration of the fluid | ||
| • After 6 h, 56% of the infused saline was retained compared with 30% of the Hartmann’s solution | ||
| Balanced solution | ||
| 1 liter (195) | 102.8 to a peak of ~104.5 at 24 h from ED arrival, slightly longer than the normal saline group | • Median fluid volume administration of 1 liter in the ED |
| • 6,708 SALT-ED participants received balanced solutions | ||
| Plasma-Lyte | ||
| 2 liters over 1 h (31) | 103.5 to 104.5 over the 1st hour and remained at that level for the next 2 h | • Serum chloride increased despite the calculated decrease in Table 2 |
ED, emergency department.