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BJA Advance Access published online on June 4, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen148
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 BJA: August 2008
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Physiological effects of hyperchloraemia and acidosis

J. M. Handy* and N. Soni

Chelsea and Westminster NHS Foundation Trust, Imperial College London, 369 Fulham Road, London SW10 9NH, UK

* Corresponding author. E-mail: j.m.handy{at}imperial.ac.uk

The advent of balanced solutions for i.v. fluid resuscitation and replacement is imminent and will affect any specialty involved in fluid management. Part of the background to their introduction has focused on the non-physiological nature of ‘normal’ saline solution and the developing science about the potential problems of hyperchloraemic acidosis. This review assesses the physiological significance of hyperchloraemic acidosis and of acidosis in general. It aims to differentiate the effects of the causes of acidosis from the physiological consequences of acidosis. It is intended to provide an assessment of the importance of hyperchloraemic acidosis and thereby the likely benefits of balanced solutions.

Keywords: acid–base equilibrium, metabolic acidosis; complications, acidosis; fluids, i.v.; ions, intracellular; metabolism, lactate


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