Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Chloride is scientifically validated as part of the treatment for hypotension, particularly in the form of intravenous (IV) fluids such as normal saline (0.9% sodium chloride). The standard of care for acute hypotension, especially in cases of hypovolemia (low blood volume), is rapid administration of isotonic saline. The chloride ion itself is not the primary active agent raising blood pressure; rather, it is the sodium component that expands intravascular volume and thus increases blood pressure. However, chloride plays a critical role in maintaining the osmotic balance and acid-base equilibrium of extracellular fluid. Clinical guidelines and multiple randomized controlled trials support the use of isotonic saline for fluid resuscitation in hypotensive patients, especially in emergency and critical care settings. Evidence shows that restoring circulating volume with saline effectively increases blood pressure and improves tissue perfusion. While balanced crystalloids (like lactated Ringer's) are sometimes preferred to avoid hyperchloremic acidosis, normal saline remains a first-line therapy due to its availability and proven efficacy. Chloride-containing solutions are not used to treat hypotension unrelated to volume depletion (such as in distributive shock without hypovolemia), but in most scenarios where hypotension is secondary to fluid loss, their use is both traditional and strongly evidence-based.

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