{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:37:34Z","timestamp":1793417854082,"version":"4.5.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"17","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>The purpose of this therapeutic update is to provide pharmacists with a general overview of the pathophysiology of hyperchloremia and describe strategies to help prevent development of this electrolyte abnormality in hospitalized patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>Hyperchloremia is an electrolyte abnormality associated with an increased incidence of acute kidney injury and metabolic acidosis. Intravenous (IV) fluids utilized for volume resuscitation, medication diluents, and total parental nutrition all may contribute to the development of hyperchloremia. Current evidence suggests that administration of balanced crystalloids for either fluid resuscitation or maintenance fluids may impact serum chloride levels and patient outcomes. In multiple randomized controlled trials, administering balanced crystalloids for fluid resuscitation in critically ill patient populations did not decrease mortality. However, further analyses of subpopulations within these trials have demonstrated that patients with sepsis may benefit from receiving balanced crystalloids for initial fluid resuscitation. Results from several small studies suggest that altering the composition of these IV fluids may help prevent development of hyperchloremia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Management of hyperchloremia is preventative in nature and can be mitigated through management of resuscitation fluids, medication diluents, and total parenteral nutrition. Inpatient pharmacists should be aware of the potential risk of fluid-associated hyperchloremia and assist with optimal fluid management to prevent and manage hyperchloremia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae086","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T05:26:10Z","timestamp":1711517170000},"page":"e462-e470","source":"Crossref","is-referenced-by-count":5,"title":["Iatrogenic hyperchloremia: An overview in hospitalized patients for pharmacists"],"prefix":"10.1093","volume":"81","author":[{"given":"Amoreena","family":"Most","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Michigan Medicine , Ann Arbor, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nordbeck","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Michigan Medicine , Ann Arbor, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Farina","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Michigan Medicine , Ann Arbor, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"issue":"1","key":"2024081905514519600_CIT0001","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40635-018-0174-5","article-title":"Serum chloride levels in critical illness\u2014the hidden story","volume":"6","author":"Pfortmueller","year":"2018","journal-title":"Intensive Care Med Exp"},{"issue":"3","key":"2024081905514519600_CIT0002","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.bpa.2014.07.001","article-title":"Balanced versus unbalanced salt solutions: what difference does it make","volume":"28","author":"Magder","year":"2014","journal-title":"Best Pract Res Clin Anaesthesiol"},{"issue":"1","key":"2024081905514519600_CIT0003","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/SLA.0b013e318256be72","article-title":"A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and Plasma-Lyte 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers","volume":"256","author":"Chowdhury","year":"2012","journal-title":"Ann Surg"},{"issue":"2","key":"2024081905514519600_CIT0004","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jcrc.2010.04.013","article-title":"Is hyperchloremia associated with mortality in critically ill patients? 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