The crystalloid fluid used in initial resuscitative efforts does not contain any clotting factors or erythrocytes (red blood cells). Its use may result in a dilution of clotting factors and erythrocytes, and therefore poorer control of bleeding and impaired oxygen transport to tissues causing further ischemic damage. Additionally, crystalloids have an acidic pH, and the administration of large quantities of isotonic or slightly hypertonic crystalloid solutions such as 0.9% normal saline or Lactated Ringer's can cause or aggravate metabolic acidosis, another component of the "Triad of Death" leading to a decrease in myocardial (heart muscle) function.