Infusion fluids: A clinical pharmacologist’s view

Infusion therapy is widely used in medical practice. However, the choice of certain solution for intravenous administration is complicated by insufficient knowledge of these medications. Objective. To summarize data of experimental, clinical and observational studies devoted to efficacy and safety of infusion fluids with different chemical compositions, as well as to demonstrate modern approaches to choosing an infusion solution for patients in intensive care units. Material and methods. We analyzed data of English-and Russian-language clinical, observational and experimental studies devoted to efficacy and safety of infusion fluids. We found 929 manuscripts in the PubMed database using the keywords “balanced crystalloids”. To narrow searching requirements, we used the keywords “balanced crystalloids vs saline” and obtained 55 man-uscripts. Then, we applied the keywords “acetate crystalloid solution” and found 229 publications. In the e-Library database, we found 177 and 56 manuscripts using the same keywords, respectively. In total, over 100 articles were analyzed and 54 manuscripts were included into this article. We excluded the studies devoted to colloid solutions. We analyzed data on the modern principles of crystalloid infusion in intensive care. Results. A comparative analysis of crystalloid and colloidal fluids and colloidal fluids of different compositions with each other was carried out. Conclusion. Despite unclear evidence and methodological shortcomings of various studies, acetate-buffered balanced crystal-loids with ionic composition as close as possible to ionic composition of blood plasma are the most perspective regarding efficacy and safety in surgical and critically ill patients. © 2021, Media Sphera Publishing Group. All rights reserved.