Perspective: The ongoing saga of normal saline vs. balanced fluids.

The ongoing saga of normal saline versus balanced fluids – First10EM

Original studies:

RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis – NEJM Evidence

Related:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline