The fractional excretion of chloride (FE(Cl)) instead of sodium (FE(Na)) indicates hypovolaemia: A comparative study of bedside assessment of true or effective intravascular depletion

Laterre, Pierre-François;Mallié, Jean-Pierre;Bollaert, Pierre Édouard
(1993) Clinical Intensive Care : international journal of critical care medicine — Vol. 4, n° 3, p. 112-115 (1993)

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  • Laterre, Pierre-FrançoisUCLouvain
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  • Mallié, Jean-Pierre
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  • Bollaert, Pierre Édouard
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Abstract
Objective: To assess if FE(Cl) can indicate both quickly and accurately an admission diagnosis of hypovolaemia, either true or effective, and if this is a better marker than FE(Na). Design: Patients were divided into three groups: normovolaemia, true hypovolaemia and effective hypovolaemia on the basis of central venous pressure, diuresis and effect of treatment. Setting: On admission, blood and urine samples were taken and FE(Cl), and FE(Na) determined within the first hour in the intensive care unit. Subjects: Patients requiring haemodynamic monitoring and bladder catheterisation were considered for entry. Certain drugs given prior to admission or organic renal failure were criteria for exclusion. Fifty-four patients were studied prospectively in whom 14 had normovolaemia, 22 true hypovolaemia and 18 effective hypovolaemia. Results: FE(Cl) was decreased in all true and effective hypovolaemia patients. There was no overlap between normovolaemia and hypovolaemia groups. A decrease in FE(Na) was noted for group means but a large overlap was seen, involving almost half of the patients. Conclusions: For group studies the classical FE(Na),a measurement could indicate hypovolaemia but it cannot be used for individual assessments. FE(Cl) lower than 0.7 % indicates hypovolaemia. Being readily available within the first hour of admission, the FE(Cl) is a better marker of hypovolaemia than the FE(Na).
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Laterre, P.-F., Mallié, J.-P., & Bollaert, P. É. (1993). The fractional excretion of chloride (FE(Cl)) instead of sodium (FE(Na)) indicates hypovolaemia: A comparative study of bedside assessment of true or effective intravascular depletion. Clinical Intensive Care : international journal of critical care medicine, 4(3), 112-115. https://hdl.handle.net/2078.5/126102 (Original work published 1993)