PT - JOURNAL ARTICLE AU - S Skellett AU - A Mayer AU - A Durward AU - S M Tibby AU - I A Murdoch TI - Chasing the base deficit: hyperchloraemic acidosis following 0.9% saline fluid resuscitation AID - 10.1136/adc.83.6.514 DP - 2000 Dec 01 TA - Archives of Disease in Childhood PG - 514--516 VI - 83 IP - 6 4099 - http://adc.bmj.com/content/83/6/514.short 4100 - http://adc.bmj.com/content/83/6/514.full SO - Arch Dis Child2000 Dec 01; 83 AB - Base deficit is a parameter often used to guide further treatment in acidotic children and is taken as a measure of how “sick” they are. Five children with septic shock are presented who had persisting base deficit after large volume resuscitation with 0.9% saline. Stewart's strong ion theory of acid–base balance is able to quantify the causes of metabolic acidosis and is used to show that our patients had a hyperchloraemic metabolic acidosis. We show how the chloride content of the saline loads given to our patients caused this hyperchloraemia. It is concluded that 0.9% saline and other chloride rich fluids may not be ideal resuscitation fluids; if used, clinicians must be aware of their potential to cause a persistent base deficit.