In a controlled dose-response study, Scheingraber
et al. compared sodium chloride 0.9% with Ringer’s
Lactate in a dosage of 30 mL/kg/h, in two groups of 12
patients without apparent cardiac, pulmonary or renal
diseases who were scheduled for elective lower
abdominal gynaecological surgery.
7
During infusion, the
pH decreased significantly from 7.41 to 7.28 (normal 7.35–
7.45) in the sodium chloride 0.9% group but not in the
Ringer’s Lactate group. Changes in the base excess were
similar to changes in pH. Serum chloride increased in
both groups, but the increase was much larger in the
sodium chloride 0.9% group. Scheingraber’s results are
in agreement with our study and the published literature.
10
The occurrence of hyperchloraemic acidosis in the
sodium chloride 0.9% group is consistent with previous
anecdotal reports of the use of large volumes of intraoperative sodium chloride 0.9%.