Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis.

The aim of this review is to investigate the relevance of dyschloremia in the critically ill. Hypo- or hyperchloremia may often be observed on ICUs, but data on relevant patient-centered clinical outcomes remain sparse.

In fact, most studies investigating “dyschloremia” were heterogeneous and hyperchloremia was a result of infusion of normal saline (and thus concomitant sodium infusion). Moreover, different laboratory methods to measure Cl−, definitions of hypo- and/or hyperchloremia, different trial design/methodology, and cohorts under investigation add to a considerable heterogeneity of the available data.

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