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Monday, 05 January 2015 11:49

The case for 0.9% NaCl: is the undefendable, defensible?

By  Can Ince
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Although 0.9% NaCl solution is by far the most-used fluid for fluid therapy in resuscitation, it is difficult to find a paper advocating its use over other types of crystalloid solutions. Literature on the deleterious effects of 0.9%NaCl has accumulated over the last decade, but critical appraisal of alternative crystalloid solutions is lacking. As such, the literature seems to suggest that 0.9% NaCl should be avoided at all costs, whereas alternative crystalloid solutions can be used without scrutiny. The basis of this negative evaluation of 0.9% NaCl is almost exclusively its effect on acid–base homeostasis, whereas the potentially deleterious effects present in other types of crystalloids are neglected. We have the challenging task of defending the use of 0.9% NaCl and reviewing its positive attributes, while an accompanying paper will argue against the use of 0.9% NaCl. It is challenging because of the large amount of literature, including our own, showing adverse effects of 0.9% NaCl. We will discuss why 0.9% NaCl solution is the most frequently used resuscitation fluid. Although it has some deleterious effects, all fluids share common features of concern. As such the emphasis on fluid resuscitation should be on volume rather than on composition and should be accompanied by a physiological assessment of the impact of fluids. In this paper, we hope to discuss the context within which fluids, specifically 0.9% NaCl, can be given in a safe and effective manner.


Authors: Can Ince and A B Johan Groeneveld

Reference: Kidney Int 86: 1087-1095; advance online publication, July 9, 2014; doi:10.1038/ki.2014.193

Additional Info

  • Language: English
  • Contains Audio: No
  • Content Type: Articles
  • Source: KI
  • Year: 2014
  • Members Only: No
Read 642 times Last modified on Monday, 08 February 2016 22:14

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