Balanced Crystalloid versus 0.9% Sodium Chloride: What We Overlook in Our Research

Infusions of crystalloid solutions are currently recommended for the treatment of critically ill patients with various pathologic conditions, including bleeding, sepsis, and trauma.^1–3  A large number of prospective randomized multicenter studies on the comparative analysis of 0.9% sodium chloride and balanced crystalloid have examined their efficacy and safety. However, the answer to the question of whether the crystalloid composition affects the treatment outcome in critically ill patients has not yet been received.¹  It should be noted that currently, when assessing the pharmacodynamic effects of crystalloid solutions, their actual physicochemical parameters, such as osmolality and pH, are not taken into account. Researchers prefer to use theoretically calculated parameters, and in our opinion, this reduces the accuracy of the results. The fact is that the theoretical osmolarity values of solutions can differ significantly from their actual osmolality...