Iatrogenic hyperchloraemic acidosis due to large volume fluid administration

Research output: Contribution to journalReview articlepeer-review


The rapid infusion of 0.9% NaCl solution produces a predictable, dose-dependent metabolic acidosis that is characterised by hyperchloraemia and a decreased plasma bicarbonate concentration. This effect has been observed for over 100 years, and the occurrence of the phenomenon is not in dispute. What is refuted is the mechanism by which 0.9% NaCl administration induces metabolic acidosis. The purpose of this review is to define the mechanism for the development of hyperchloraemic acidosis, clarify methods for its clinical recognition, and develop an appropriate treatment protocol for this common iatrogenic acid-base disorder.

Original languageEnglish (US)
Pages (from-to)111-122
Number of pages12
JournalInternational Journal of Intensive Care
Issue number3
StatePublished - Sep 2005

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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