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Saline has a Na<jats:sup>+<\/jats:sup>:Cl<jats:sup>-<\/jats:sup>of 1:1 and can produce hyperchloraemic acidosis, renal vasoconstriction and reduced glomerular filtration rate. In contrast, the more physiological Hartmann's solution with a Na<jats:sup>+<\/jats:sup>:Cl<jats:sup>-<\/jats:sup>of 1\u00b718:1 does not cause hyperchloraemia and Na excretion following infusion is more rapid. Salt and water overload causes not only peripheral and pulmonary oedema, but may also produce splanchnic oedema, resulting in ileus or acute intestinal failure. This overload may sometimes be an inevitable consequence of resuscitation, yet it may take 3 weeks to excrete this excess. It is important to avoid unnecessary additional overload by not prescribing excessive maintenance fluids after the need for resuscitation has passed. Most patients require 2\u20132\u00b75 litres water and 60\u2013100?mmol?Na\\d for maintenance in order to prevent a positive fluid balance. This requirement must not be confused with those for resuscitation of the hypovolaemic patient in whom the main aim of fluid therapy is repletion of the intravascular volume. Fluid and electrolyte balance is a vital component of the metabolic care of surgical and critically-ill patients, with important consequences for gastrointestinal function and hence nutrition. It is also of importance when prescribing artificial nutrition and should be given the same careful consideration as other nutritional and pharmacological needs.<\/jats:p>","DOI":"10.1079\/pns2004376","type":"journal-article","created":{"date-parts":[[2004,10,14]],"date-time":"2004-10-14T23:27:22Z","timestamp":1097796442000},"page":"453-466","source":"Crossref","is-referenced-by-count":91,"title":["Fluid, electrolytes and nutrition: physiological and clinical aspects"],"prefix":"10.1017","volume":"63","author":[{"given":"Dileep N.","family":"Lobo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2007,3,7]]},"reference":[{"key":"S0029665104000631_ref082","doi-asserted-by":"publisher","DOI":"10.1042\/cs0730285"},{"key":"S0029665104000631_ref091","first-page":"560","article-title":"Proctoclysis \u2013 an experimental study","volume":"16","author":"Trout","year":"1913","journal-title":"Surgery Gynecology and Obstetrics"},{"key":"S0029665104000631_ref090","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200001000-00018"},{"key":"S0029665104000631_ref094","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1970.03180090074027"},{"key":"S0029665104000631_ref085","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg102"},{"key":"S0029665104000631_ref098","first-page":"999","article-title":"The effect of intravenous lactated Ringer's solution versus 0\u00b79% sodium chloride solution on serum osmolality in human volunteers","volume":"88","author":"Williams","year":"1999","journal-title":"Anesthesia and Analgesia"},{"key":"S0029665104000631_ref081","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7113.909"},{"key":"S0029665104000631_ref087","first-page":"82","article-title":"Variability in post-operative fluid and electrolyte prescription","volume":"51","author":"Stoneham","year":"1997","journal-title":"British Journal of Clinical Practice"},{"key":"S0029665104000631_ref096","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(49)91741-9"},{"key":"S0029665104000631_ref086","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197709000-00012"},{"key":"S0029665104000631_ref100","first-page":"758","article-title":"Oncotic pressure, albumin and ileus: the effect of albumin replacement on postoperative ileus","volume":"59","author":"Woods","year":"1993","journal-title":"American Surgeon"},{"key":"S0029665104000631_ref077","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg101"},{"key":"S0029665104000631_ref076","doi-asserted-by":"publisher","DOI":"10.1080\/00365520310000726"},{"key":"S0029665104000631_ref072","first-page":"65","volume-title":"Surgery Principles and Practice","author":"Rhoads","year":"1957"},{"key":"S0029665104000631_ref074","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196902000-00001"},{"key":"S0029665104000631_ref078","first-page":"115","article-title":"Distributional changes in extracellular fluid during acute hemorrhagic shock","volume":"11","author":"Shires","year":"1960","journal-title":"Surgical Forum"},{"key":"S0029665104000631_ref066","first-page":"788","article-title":"Disorders of body fluid balance: a new look into the mechanism of disease","volume":"11","author":"Plante","year":"1995","journal-title":"Candian Journal of Cardiology"},{"key":"S0029665104000631_ref073","volume-title":"Clinical Physiology of Acid-base and Electrolyte Disorders","author":"Rose","year":"2001"},{"key":"S0029665104000631_ref068","unstructured":"Price J , Sear J & Venn R (2002) Perioperative fluid volume optimization following proximal femoral fracture. 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