Balanced crystalloids versus isotonic saline in critically ill patients: systematic review and meta-analysis

Journal of Intensive Care
Yazan Z M ZayedGhassan I Bachuwa

Abstract

Intravenous fluids are one of the most used medical therapy for patients, especially critically ill patients. We conducted a meta-analysis comparing between balanced crystalloids and normal saline in critically ill patients and its effect on various clinical outcomes. Meta-analysis and systematic review of randomized clinical trials (RCTs). Electronic search was performed using PubMed, Cochrane library, and clinical trials.gov from inception through March 1, 2018, with inclusion of prospective studies that investigated one of the primary outcomes which were acute kidney injury (AKI) and in-hospital mortality while secondary outcomes were intensive care unit (ICU) mortality and new renal replacement therapy (RRT). Six RCTs were included. Total of 19,332 patients were included in the final analysis. There was no significant difference in in-hospital mortality (11.5% vs 12.2%; OR 0.92; 95% CI 0.85-1.01; P = 0.09; I2 = 0%), incidence of AKI (12% vs 12.7%, OR 0.92; 95% CI 0.84-1.01; P = 0.1; I2 = 0), overall ICU mortality (OR 0.9, 95% CI 0.81-1.01, P = 0.08, I2 = 0%), or need for new RRT (OR 0.92, 95% CI 0.67-1.28, P = 0.65, I2 = 38%) between balanced crystalloids and isotonic saline in critically ill patients. Balanced crystalloids...Continue Reading

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Citations

Dec 13, 2018·American Journal of Physiology. Renal Physiology·Joshua L Rein, Steven G Coca
Jul 25, 2019·The Cochrane Database of Systematic Reviews·Alba M Antequera MartínMaria N Plana
Aug 29, 2020·Der Internist·M KochanekB Böll
Aug 27, 2019·Critical Care Nursing Quarterly·Sreejith M VelliyattikuzhiTariq Cheema
Nov 23, 2019·Critical Care : the Official Journal of the Critical Care Forum·Charlotte L ZwagerPaul W G Elbers
Dec 2, 2020·Critical Care Nurse·Ashley BarlowAmber E King

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