The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
Fluid resuscitation and hyperchloremic acidosis in experimental sepsis: Improved short-term survival and acid-base balance with Hextend compared with saline
Abstract
OBJECTIVE: To compare resuscitation with 0.9% saline with Hextend, a synthetic colloid in a balanced electrolyte solution, in terms of acid-base status and survival time in an experimental model of septic shock in the rat. DESIGN: Randomized, open-label, controlled experiment. SETTING: University research laboratory. SUBJECTS: Sixty adult, male Sprague-Dawley rats. INTERVENTION: Animals were studied for 12 hrs after intravenous infusion of Escherichia coli endotoxin (20 mg/kg). Animals were volume resuscitated to maintain a mean arterial pressure >60 mm Hg using either 0.9% saline (n = 25), Hextend (n = 25), or lactated Ringer's (n = 10). MEASUREMENTS: Arterial blood gases and electrolytes were measured before and after resuscitation (0, 180, 360, and 540 mins after endotoxin infusion). Survival time was measured, up to 12 hrs. RESULTS: Mean survival time among animals treated with saline or Ringer's was 45% less compared with Hextend-treated animals: 391 +/- 151 mins and 362 +/- 94 mins vs. 567 +/- 140 mins, respectively, p <.0001. Overall survival (at 12 hrs) was 0% with saline or Ringer's vs. 20% with Hextend, p =.05. After resuscitation with saline, arterial standard base excess and plasma apparent strong ion difference were both significantly lower (-19.3 +/- 5.2 vs. -12.1 +/- 5.7, p <.001, and 23.0 +/- 6.2 vs. 30.3 +/- 2.9, p <.0001, respectively) and plasma Cl(-) was significantly higher (123 +/- 7 vs. 115 +/- 3 mmol/L, p <.0001) compared with Hextend. Resuscitation with Ringer's solution resulted in a standard base excess, and Cl(-) between that of saline and Hextend (-15.4 +/- 3.1, and 117 +/- 3, respectively). CONCLUSION: Compared with 0.9% saline, volume resuscitation with Hextend was associated with less metabolic acidosis and longer survival in this experimental animal model of septic shock.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“potential adverse effects that include hyperchloremic metabolic acidosis, renal vasoconstriction, increased cytokine secretion and concern about acute kidney injury (AKI) have led to increased interest in chloride-restrictive solutions, known as balanced or buffered solutions [326–330].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [327]
Citations
Cites
Modern quantitative acid–base chemistry
Stewart, P. A. (1983) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/y83-207 · Cited by 1,366
Hickling, K. G., Henderson, S. J., & Jackson, R. (1990) · Intensive Care Medicine · doi:10.1007/bf01735174 · Cited by 923
Rapid Saline Infusion Produces Hyperchloremic Acidosis in Patients Undergoing Gynecologic Surgery
Scheingraber, S., Rehm, M., Sehmisch, C., & FINSTERER, U. (1999) · Anesthesiology · doi:10.1097/00000542-199905000-00007 · Cited by 750
Schierhout, G., & Roberts, I. (1998) · BMJ · doi:10.1136/bmj.316.7136.961 · Cited by 639
Wilkes, N. J., Woolf, R. L., Mutch, M., Mallett, S., Peachey, T., Stephens, R. C. M., & Mythen, M. G. (2001) · Anesthesia & Analgesia · doi:10.1097/00000539-200110000-00003 · Cited by 458
Practice parameters for hemodynamic support of sepsis in adult patients in sepsis
(1999) · Critical Care Medicine · doi:10.1097/00003246-199903000-00049 · Cited by 434
Gilbert, E. M., Haupt, M. T., Mandanas, R. Y., Huaringa, A. J., & Carlson, R. W. (1986) · American Review of Respiratory Disease · doi:10.1164/arrd.1986.134.5.873 · Cited by 363
Serum proteins and acid-base equilibria: a follow-up.
Figge, J. J., Mydosh, T., & Fencl, V. (1992) · PubMed · Cited by 349
Sodium Bicarbonate for the Treatment of Lactic Acidosis
Forsythe, S. M., & Schmidt, G. A. (2000) · CHEST Journal · doi:10.1378/chest.117.1.260 · Cited by 338
Strong ion gap: A methodology for exploring unexplained anions
Kellum, J. A., Kramer, D. J., & Pinsky, M. R. (1995) · Journal of Critical Care · doi:10.1016/0883-9441(95)90016-0 · Cited by 321
Self-citationMartich, G. D., Boujoukos, A. J., & Suffredini, A. F. (1993) · Immunobiology · doi:10.1016/s0171-2985(11)80353-0 · Cited by 275
Siggaard‐Andersen, O., & Fogh‐Andersen, N. (1995) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.1995.tb04346.x · Cited by 253
ETIOLOGY OF METABOLIC ACIDOSIS DURING SALINE RESUSCITATION IN ENDOTOXEMIA
Kellum, J. A., Bellomo, R., Kramer, D. J., & Pinsky, M. R. (1998) · Shock · doi:10.1097/00024382-199805000-00009 · Cited by 208
Self-citationNatural history and course of acquired lactic acidosis in adults
Stacpoole, P. W., Wright, E. C., Baumgartner, T. G., Bersin, R. M., Buchalter, S. E., Curry, S. H., Duncan, C. A., Harman, E. M., Henderson, G. N., Jenkinson, S., et al. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90047-7 · Cited by 190
Tulzo, Y. L., Shenkar, R., Kaneko, D., Moine, P., Fantuzzi, G., Dinarello, C. A., & Abraham, E. H. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119314 · Cited by 187
Prough, D. S., & Bidani, A. (1999) · Anesthesiology · doi:10.1097/00000542-199905000-00003 · Cited by 180
Cause of metabolic acidosis in prolonged surgery
Waters, J. H., Miller, L. R., Clack, S., & Kim, J. V. (1999) · Critical Care Medicine · doi:10.1097/00003246-199910000-00011 · Cited by 163
Role of Pump Prime in the Etiology and Pathogenesis of Cardiopulmonary Bypass–associated Acidosis
Liskaser, F., Bellomo, R., Hayhoe, M., Story, D., Poustie, S., Smith, B. L., Letis, A., & Bennett, M. R. (2000) · Anesthesiology · doi:10.1097/00000542-200011000-00006 · Cited by 162
Lactated Ringer's Is Superior to Normal Saline in a Model of Massive Hemorrhage and Resuscitation
Healey, M. A., Davis, R. E., Liu, F. C., Loomis, W. H., & Hoyt, D. B. (1998) · doi:10.1097/00005373-199811000-00010 · Cited by 135
Rehm, M., Orth, V. H., Scheingraber, S., Kreimeier, U., Brechtelsbauer, H., & FINSTERER, U. (2000) · Anesthesiology · doi:10.1097/00000542-200011000-00007 · Cited by 129
Injurious Effects of Hypocapnic Alkalosis in the Isolated Lung
Laffey, J. G., Engelberts, D., & Kavanagh, B. P. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.162.2.9911026 · Cited by 127
Unaccounted for anion in metabolic acidosis during severe sepsis in humans
Mecher, C., Rackow, E. C., Astiz, M. E., & Weil, M. H. (1991) · Critical Care Medicine · doi:10.1097/00003246-199105000-00018 · Cited by 95
Effect of extracellular pH on function and metabolism of isolated perfused rat heart
Opie, L. H. (1965) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1965.209.6.1075 · Cited by 85
Dilutional Acidosis following Hetastarch or Albumin in Healthy Volunteers
Waters, J. H., & Bernstein, C. A. (2000) · Anesthesiology · doi:10.1097/00000542-200011000-00008 · Cited by 83
Metabolic acidosis in the critically ill: lessons from physical chemistry.
Kellum, J. A. (1998) · PubMed · Cited by 77
Self-citationLactic acidosis increases tumor necrosis factor secretion and transcription in vitro
Jc, J., Buresh, C. M., & Norton, J. A. (1990) · Journal of Surgical Research · doi:10.1016/0022-4804(90)90036-2 · Cited by 69
Acidosis Associated with Perioperative Saline Administration
Prough, D. S., & White, R. T. (2000) · Anesthesiology · doi:10.1097/00000542-200011000-00005 · Cited by 62
Bicarbonate Does Not Increase Left Ventricular Contractility During L-Lactic Acidemia in Pigs
Cooper, D. J., Herbertson, M., Werner, H., & Walley, K. R. (1993) · American Review of Respiratory Disease · doi:10.1164/ajrccm/148.2.317 · Cited by 46
Research works printed but not linked: 3
- Figge, 1992, J Lab Clin Med, 120, 713
- Kellum, 1998, Kidney Int, 66, S81
- Opie, 1965, J Appl Physiol, 209, 1975
Cited by
Sorted by citations
Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06506-y · Cited by 5,082
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005337 · Cited by 2,935
Balanced crystalloids versus saline in critically ill adults.
Semler, M. W., Self, W. H., Wanderer, J. P., Ehrenfeld, J. M., Wang, L., Byrne, D. W., Stollings, J. L., Kumar, A. B., Hughes, C. G., Hernandez, A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1711584 · Cited by 1,433
Balanced Crystalloids versus Saline in Noncritically Ill Adults
Self, W. H., Semler, M. W., Wanderer, J. P., Wang, L., Byrne, D. W., Collins, S. P., Slovis, C. M., Lindsell, C. J., Ehrenfeld, J. M., Siew, E. D., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1711586 · Cited by 1,170
Wu, B. U., Hwang, J. Q., Gardner, T., Repas, K. A., DeLee, R., Yu, S. Y., Smith, B. N., Banks, P. A., & Conwell, D. L. (2011) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2011.04.026 · Cited by 559
Metadata
- Authors
- Kellum, J. A.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Kellum, John A.
- ORCID
- Kellum, John A.
- Venue
- Critical Care Medicine
- Published
- 2002-02
- Volume
- 30
- Issue
- 2
- Pages
- 300-305
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2091601305
- Cited by
- 249
- References
- 28
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 4 · 2023: 13 · 2022: 9 · 2021: 11 · 2020: 2 · 2019: 4 · 2018: 18 · 2017: 6 · 2016: 5 · 2015: 11 · 2014: 12 · 2013: 8 · 2012: 6
- FWCI
- 10.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Center, University of Pittsburgh
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- fluid resuscitation, hyperchloremic metabolic acidosis, septic shock, Hextend, synthetic colloids, 0.9% saline, lactated Ringer's solution, endotoxin, acid-base balance, strong ion difference, base excess, plasma chloride, short-term survival, rats, electrolyte balance
- MeSH terms
- Acid-Base Equilibrium, Acidosis, Analysis of Variance, Animals, Fluid Therapy, Hydroxyethyl Starch Derivatives, Male, Plasma Substitutes, Random Allocation, Shock, Septic, Sodium Chloride, Survival Analysis, Rats, Sprague-Dawley, Rats
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review