The battle over the superiority of resuscitation fluids is coming to a boil. Enter the Fluid Wars. Are Lactated Ringers superior to normal saline? Will LR increase a patient’s lactate? What about albumin? The Curbsiders quench the thirst for knowledge by turning to masters Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) for guidance in this special @NephMadness episode that will get your feet wet with the complicated world of fluid resuscitation.
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Written and produced by: Justin Berk MD, Pascale Khairallah MD
NephMadness Pun Contest produced by: Hannah R Abrams MS3
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto MD
Guest: Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD
- 00:00 Nephmadness pun contest
- 02:18 Disclaimer
- 02:52 Intro to the show and NephMadness, guest bios
- 08:04 Guest one-liners,
- 10:58 Joel explains NephMadness
- 12:58 Guest book recommendations and career advice
- 17:30 Clinical case; goals of fluid resuscitation; choice of initial IV fluid
- Corporate (TV series) Comedy Central
- 19:41 Complications of normal saline
- 21:29 Colloids versus crystalloids
- LR versus normal saline is not an innocuous decision
- 26:32 Saline versus balance fluids. What’s the makeup?
- 28:19 Does lactated ringers elevate lactate?
- 31:03 Is hyperkalemia a contraindication for LR?
- 32:39 Lactated ringers versus plasma-lyte and cost of fluid
- 34:49 In vitro risks of normal saline
- 40:31 SMART and SALT-ED trial
- 46:08 Stuart finds the IV fluid price list
- 44:37 Each panelist weighs in on saline versus balanced fluids
- 46:45 Why do patients with metabolic alkalosis thrive on saline?
- 49:04 Outro