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Adequate fluid resuscitation is one of the key treatment modalities in critically ill patients. In contrast, fluid overload can also affect other organs such as brain edema, pulmonary edema, hepatic congestion. Not only the amount of fluid administration but also the type of intravenous fluid is important. Recent publications have shown that hydroxyethyl starch caused damage to the kidney in the critically ill setting. Moreover, there is increasing evidence that chloride-restricted solutions may improve clinical outcomes.
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