Acute Caremiddle twist
A 58-year-old man was admitted 36 hours ago with severe acute pancreatitis and has been given 7 litres of sodium chloride 0.9%. He is alert and normotensive, is passing 60 mL of urine an hour, and still needs intravenous fluid. He is not diabetic and takes no regular medicines. Venous blood gas and biochemistry show pH 7.29, bicarbonate 17 mmol/L, sodium 141 mmol/L, potassium 4.2 mmol/L, lactate 0.9 mmol/L and creatinine 130 micromol/L, the creatinine having been 88 micromol/L on admission. Which one of the following fluids should now be charted?