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Table 1 Potentially deleterious effects of high Cl--content secondary to administration of large volume of 0.9 % saline addressed in the literature

From: The great fluid debate: saline or so-called “balanced” salt solutions?

• Hyperchloremic metabolic acidosis (traditionally called dilution acidosis)  
• Acute kidney injury with reduced urine output and increase in interstitial fluid volume  
• Hyperkalemia (K+ mobilized from the intracellular space)  
• Damaged endothelial surface layer with increased vascular permeability and stiffness  
• Increase in proinflammatory mediators and tendency to infections  
• Detrimental effect on coagulation with tendency to blood loss  
• Detrimental gastrointestinal perfusion and function  
• Possible uneasiness at the bedside resulting in unnecessary administration of more fluids