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0.9% Sodium Chloride: The Drug We Give Without Thinking (Free Preview) | Anesthesia Drug Compendium Series

Normal" saline is not normal. Plasma runs Na⁺ ≈ 140 and Cl⁻ ≈ 100; the bag holds 154 of each at 308 mOsm/L. The supraphysiological chloride — half again above normal — defines everything modern medicine worries about in the bag.

This episode covers: the 1832 cholera outbreak that invented IV fluid resuscitation, Hamburger's 1896 red-cell experiments that gave us the "0.9%" (and overshot the true isotonic value), hyperchloremic metabolic acidosis via the Stewart strong-ion-difference mechanism, the 2018 SMART and SALT-ED trials, and the three jobs no balanced crystalloid does better than normal saline.

The full episode, available on Supercast >>> https://diaryofaloststudent.supercast.com/

Timestamps

00:42 — "Normal" is not normal

01:16 — The modern formulation

01:40 — The full episode continues on Supercast...

Full Episode

The complete saline episode — is on Supercast https://diaryofaloststudent.supercast.com/

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