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Tag: Normal Saline

SCOPE-DKA: Normal Saline vs Plasmalyte in Severe DKA

Background Information:  Diabetic Ketoacidosis (DKA) is a life-threatening complication of diabetes that we frequently encounter in both the emergency department (ED) and intensive care unit (ICU). While intravenous fluid replacement remains one of several cornerstones of therapies, much debate exists …

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Endocrine, Metabolic, Fluid, and ElectrolytesResuscitation

REBEL Core Cast 26.0 – Lactated Ringers

Take Home Points When compared to 0.9% saline, lactated ringers is a more balanced solution and more closely resembles our serum. SALT ED and SMART trials show normal saline may increase the occurrence of major adverse kidney events in comparison …

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Endocrine, Metabolic, Fluid, and ElectrolytesResuscitation

Does Lactated Ringers (LR) Raise Serum Lactate?

Background: Serial lactate measurements is a common core measure that we follow in septic shock resuscitation. A number of readers have written in enquiring about whether resuscitation with lactated ringers instead of 0.9% saline would lead to increases in serum lactate.   …

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Endocrine, Metabolic, Fluid, and Electrolytes

Rebellion in EM 2019: What the Fluid? Wieters vs Bryant

Normal saline started being used based on work done in the 1830s with cholera.  We are still doing the same thing the same way and it’s not until recently we have begun to ask the hard questions about why we …

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Endocrine, Metabolic, Fluid, and Electrolytes

Is the Great Debate Between Balanced vs Unbalanced Crystalloids Finally Over?

Background:  Normal Saline (NS) is one of the most commonly used IVFs in resuscitation today.  The use of balanced vs unbalanced crystalloids has been one of the biggest debates in resuscitation of the critically ill in recent history due to …

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Endocrine, Metabolic, Fluid, and Electrolytes

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