Table 1 Recent randomized controlled trials comparing saline 0.9% versus balanced crystalloids
From: Pathophysiology of fluid administration in critically ill patients
Study | SPLIT [77] | SMART [78] | BaSICS [62] | PLUS [79] |
|---|---|---|---|---|
Setting | 4 ICUs in New Zealand | 5 ICUs in single center in USA | 75 ICUs in Brazil | 53 ICUs in Australia and New Zealand |
Study design | Double-blind, cluster-randomized, double-crossover trial | Open-label, cluster-crossover trial | Double-blind, factorial, randomized clinical trial | Double-blind randomized controlled trial |
Number of participants | 2,278 | 15,802 | 11,052 | 5,037 |
Population | Critically ill adults (mainly surgical) | Critically ill adults | Critically ill adults (~ 50% elective surgery) | Critically ill adult patients (expected to stay in the ICU for at least 72 h) |
Intervention | Plasmalyte | RLS/Plasmalyte | Plasmalyte | Balanced multielectrolyte solution |
Control | 0.9% NaCl | 0.9% NaCl | 0.9% NaCl | 0.9% NaCl |
Primary outcome (intervention vs control) | AKI (9.6% vs 9.2%; p = 0.77) | MAKE30 (14.3% vs 15.4%; p = 0.04) | 90-day mortality (26.4% vs 27.2%; p = 0.47) | 90-day mortality (21.8% vs 22%; p = 0.90) |
Secondary outcomes (intervention vs control) | In-hospital mortality (7.6% vs 8.6%) RRT (3.3% vs 3.4%) | In-hospital mortality (25.2% vs 29.4%) RRT (2.5% vs 2.9%) | AKI with RRT (0.88% vs 0.93%) NeuroSOFA > 2 (32.1% vs 26%) | New RRT (12.7% vs 12.9%) No significant difference in maximum increase in serum creatinine |