Derby’s Finest

Two excellent recent articles from local clinicians that had to be featured on Critical Insight. An upcoming post will include a review article on Ketamine in ICU, but first…

Should we really be more “balanced” in our fluid prescribing ? Morris, C. Boyd, A. Reynolds, N. Anaesthesia, 2009 Jul;64(7):703.

A very good editorial questioning the rush away from hypercholreamic solutions despite the lack of clear evidence of benefit. They’re making a habit of insightful editorials. Without stealing their thunder, they make some excellent points regarding the potential physiological impact of negative anions (such as lactate and acetate) in situations of poor organ perfusion. A question the editorial doesn’t ask which springs to mind – how are we to assess the risk of fluid regimens without having to repeat the SAFE study for every potential option? At the same time can we tolerate the introduction of new fluids into the critically ill with very little evidence base ?

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