Balanced crystalloids versus saline in Critically Ill adults

New England Journal of Medicine

Volumn 378, Issue 9, 2018, Pages 829-839

  Semler, Matthew W ^a   Self, Wesley H ^b   Wanderer, Jonathan P ^b   Ehrenfeld, Jesse M ^b   Wang, Li ^b   Byrne, Daniel W ^b   Stollings, Joanna L ^b   Kumar, Avinash B ^b   Hughes, Christopher G ^b   Hernandez, Antonio ^b   Guillamondegui, Oscar D ^b   May, Addison K ^b   Weavind, Liza ^b   Casey, Jonathan D ^a   Siew, Edward D ^b   Shaw, Andrew D ^b   Bernard, Gordon R ^a   Rice, Todd W ^a  

^a Division of Allergy   (United States)

^b VANDERBILT UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETIC ACID PLUS GLUCONATE SODIUM PLUS MAGNESIUM CHLORIDE PLUS POTASSIUM CHLORIDE PLUS SODIUM CHLORIDE; BICARBONATE; CHLORIDE; RINGER LACTATE SOLUTION; SODIUM CHLORIDE; ELECTROLYTE; ISOTONIC SOLUTION; RINGER'S LACTATE;

ADULT; AGED; ARTICLE; CLINICAL ASSESSMENT; CLINICAL EVALUATION; CLINICAL OUTCOME; COMPARATIVE EFFECTIVENESS; CONTROLLED STUDY; CREATININE BLOOD LEVEL; CRITICALLY ILL PATIENT; CROSSOVER PROCEDURE; FEMALE; FLUID THERAPY; HOSPITAL MORTALITY; HUMAN; INTENSIVE CARE UNIT; KIDNEY FAILURE; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RENAL REPLACEMENT THERAPY; SENSITIVITY ANALYSIS; CLINICAL TRIAL; COMPARATIVE STUDY; CRITICAL ILLNESS; HOSPITAL EMERGENCY SERVICE; INTRAVENOUS DRUG ADMINISTRATION; KIDNEY DISEASE; MIDDLE AGED; MORTALITY; MULTICENTER STUDY; STATISTICS AND NUMERICAL DATA;

ADULT; AGED; CRITICAL ILLNESS; CROSS-OVER STUDIES; ELECTROLYTES; EMERGENCY SERVICE, HOSPITAL; FEMALE; FLUID THERAPY; HUMANS; INFUSIONS, INTRAVENOUS; INTENSIVE CARE UNITS; ISOTONIC SOLUTIONS; KIDNEY DISEASES; MALE; MIDDLE AGED; RENAL REPLACEMENT THERAPY; SODIUM CHLORIDE;

EID: 85042695561     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJMoa1711584     Document Type: Article

References (37)

1. Myburgh JA, Mythen MG. Resuscitation fluids. N Engl J Med 2013; 369: 1243-51.
2. Finfer S, Liu B, Taylor C, et al. Resuscitation fluid use in critically ill adults: an international cross-sectional study in 391 intensive care units. Crit Care 2010; 14:R185.
3. Awad S, Allison SP, Lobo DN. The history of 0.9% saline. Clin Nutr 2008; 27: 179-88.
4. Yunos NM, Kim IB, Bellomo R, et al. The biochemical effects of restricting chloride-rich fluids in intensive care. Crit Care Med 2011;39:2419-24.
5. Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA 2012;308:1566-72.
6. Raghunathan K, Shaw A, Nathanson B, et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis. Crit Care Med 2014; 42: 1585-91.
7. Rochwerg B, Alhazzani W, Sindi A, et al. Fluid resuscitation in sepsis: a systematic review and network meta-analysis. Ann Intern Med 2014; 161: 347-55.
8. Hammond NE, Taylor C, Finfer S, et al. Patterns of intravenous fluid resuscitation use in adult intensive care patients between 2007 and 2014: an international cross-sectional study. PLoS One 2017; 12(5):e0176292.
9. Shaw AD, Raghunathan K, Peyerl FW, Munson SH, Paluszkiewicz SM, Schermer CR. Association between intravenous chloride load during resuscitation and inhospital mortality among patients with SIRS. Intensive Care Med 2014; 40: 1897-905.
10. Shaw AD, Bagshaw SM, Goldstein SL, et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte. Ann Surg 2012; 255: 821-9.
11. Young P, Bailey M, Beasley R, et al. Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the intensive care unit: the SPLIT randomized clinical trial. JAMA 2015; 314: 1701-10.
12. Semler MW, Wanderer JP, Ehrenfeld JM, et al. Balanced crystalloids versus saline in the intensive care unit: the SALT randomized trial. Am J Respir Crit Care Med 2017;195:1362-72.
13. Semler MW, Self WH, Wang L, et al. Balanced crystalloids versus saline in the intensive care unit: study protocol for a cluster-randomized, multiple-crossover trial. Trials 2017;18:129.
14. Self WH, Semler MW, Wanderer JP, et al. Balanced crystalloids versus saline in noncritically ill adults. N Engl J Med 2018; 378:819-28.
15. Self WH, Semler MW, Wanderer JP, et al. Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial. Trials 2017;18:178.
16. Semler MW, Rice TW, Shaw AD, et al. Identification of major adverse kidney events within the electronic health record. J Med Syst 2016; 40: 167.
17. Shaw A. Models of preventable disease: contrast-induced nephropathy and cardiac surgery-associated acute kidney injury. Contrib Nephrol 2011; 174: 156-62.
18. Palevsky PM, Molitoris BA, Okusa MD, et al. Design of clinical trials in acute kidney injury: report from an NIDDK workshop on trial methodology. Clin J Am Soc Nephrol 2012;7:844-50.
19. Kashani K, Al-Khafaji A, Ardiles T, et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit Care 2013; 17: R25.
20. Kellum JA, Zarbock A, Nadim MK. What endpoints should be used for clinical studies in acute kidney injury? Intensive Care Med 2017; 43: 901-3.
21. Závada J, Hoste E, Cartin-Ceba R, et al. A comparison of three methods to estimate baseline creatinine for RIFLE classification. Nephrol Dial Transplant 2010; 25:3911-8.
22. Kidney Disease Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2012; 2:Suppl:1-138.
23. Parienti J-J, Kuss O. Cluster-crossover design: a method for limiting clusters level effect in community-intervention studies. Contemp Clin Trials 2007; 28: 316-23.
24. Turner RM, White IR, Croudace T. Analysis of cluster randomized cross-over trial data: a comparison of methods. Stat Med 2007;26:274-89.
25. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-12.
26. Shahian DM, Wolf RE, Iezzoni LI, Kirle L, Normand S-LT. Variability in the measurement of hospital-wide mortality rates. N Engl J Med 2010; 363: 2530-9.
27. Kellum JA, Bellomo R, Kramer DJ, Pinsky MR. Etiology of metabolic acidosis during saline resuscitation in endotoxemia. Shock 1998;9:364-8.
28. Kellum JA, Song M, Almasri E. Hyperchloremic acidosis increases circulating inflammatory molecules in experimental sepsis. Chest 2006;130:962-7.
29. Wilcox CS. Regulation of renal blood flow by plasma chloride. J Clin Invest 1983;71:726-35.
30. Zhou F, Peng Z-Y, Bishop J V, Cove ME, Singbartl K, Kellum JA. Effects of fluid resuscitation with 0.9% saline versus a balanced electrolyte solution on acute kidney injury in a rat model of sepsis. Crit Care Med 2014;42(4):e270-e278.
31. Kellum JA, Song M, Venkataraman R. Effects of hyperchloremic acidosis on arterial pressure and circulating inflammatory molecules in experimental sepsis. Chest 2004;125:243-8.
32. Kellum JA. Fluid resuscitation and hyperchloremic acidosis in experimental sepsis: improved short-term survival and acid-base balance with Hextend compared with saline. Crit Care Med 2002; 30: 300-5.
33. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and Plasma-Lyte 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 2012; 256: 18-24.
34. Krajewski ML, Raghunathan K, Paluszkiewicz SM, Schermer CR, Shaw AD. Meta-analysis of high-versus low-chloride content in perioperative and critical care fluid resuscitation. Br J Surg 2015; 102:24-36.
35. Sen A, Keener CM, Sileanu FE, et al. Chloride content of fluids used for large-volume resuscitation is associated with reduced survival. Crit Care Med 2017; 45(2): e146-e153.
36. Rochwerg B, Alhazzani W, Gibson A, et al. Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis. Intensive Care Med 2015; 41: 1561-71.
37. Wunsch H, Angus DC, Harrison DA, et al. Variation in critical care services across North America and Western Europe. Crit Care Med 2008; 36(10): 2787-93, e1-9.