So I was totally sold on this concept by Josh a couple of years ago and have been using it regularly. Why? Because it makes plenty of physiological sence and frankly, what is being commonly done makes a lot less. Evidence? Weak, but consistent evidence across the balanced vs chloride-rich and thrown in the BICAr-ICU and its enough for me to feel good about it until something even better comes along. Not missing that initial opportunity is the key. But let me let Josh convince you!

Josh has an IBCC chapter on this here:

https://emcrit.org/pulmcrit/fluid/

Make sure to read it!

Hope you enjoyed!

and for more…

can be found here!

Philippe