Introduction: Selecting the best balanced crystalloid
MYTH #1: Plasmalyte is significantly more alkalinizing than LR.
|Predicted effect of infusing various crystalloids into a hypothetical 70-kg patient on standard base excess (SBE). It is predicted that Plasmalyte and NS have equal and nearly opposite effects on the SBE (Omron 2009).|
MYTH #2: Sodium gluconate in Normosol and Plasmalyte is rapidly metabolized, yielding bicarbonate.
Truth: Plasmalyte doesn’t have the predicted pH effect because of failure to metabolize gluconate.
Gluconate excreted in the urine may act as an osmotic diuretic
MYTH #3: The lactate in LR may accumulate and cause a dangerous lactic acidosis.