In reply: Franke presents some well known problems associated with intravenous administration of large volumes of 0.9% NaCl, particularly its relatively slow elimination (as compared with Hartmann’s solution), and hyperchloraemic acidosis.1 In isolation, we do not dispute these facts. However, 0.9% NaCl is not unique in having problems — no intravenous fluid therapy is without risk, especially when given in excessive volume, or when the composition is inappropriate for the patient’s needs.
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- Intensive Care Unit, Alfred Hospital, Melbourne, VIC.
- 1. Awad S, Allison, SP, Lobo DN. The history of 0.9% saline. Clin Nutr 2008; 27: 179-188.
- 2. Hilton AK, Pellegrino VA, Scheinkestel CD. Avoiding common problems associated with intravenous fluid therapy. Med J Aust 2008; 189: 509-513. <MJA full text>