April 18, 2018 – Saline


Anchor lead: Which fluids are best to use in critically ill people? Elizabeth Tracey reports

The fluid known as saline is used a lot in medicine, but now a new study shows that fluids that are closer in composition to bodily fluids may be better. David Hager, a critical care medicine expert at Johns Hopkins, frames up the issue.

Hager: We do a lot of fluid resuscitation in the intensive care unit that has historically been done with normal saline, and sometimes with lactated Ringer’s, which has a few more of the typical electrolytes that are in the serum whereas normal saline is just sodium and chloride.  :14

Hager describes the findings.

Hager: They randomized their ICUs on a monthly basis to provide either normal saline versus a balanced fluid. They found that within 15,000 patients studied that the patients who had the normal saline more often had a composite endpoint of either death, prolonged renal dysfunction or need for renal replacement therapy.  :22

Hager welcomes this study as helping inform best clinical practice when it comes to which fluids are best, noting that further study is still needed. At Johns Hopkins, I’m Elizabeth Tracey.