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Fluid therapy is ubiquitous in ICU. Thus, even small differences in clinical outcomes according to the type of fluid have significant repercussions for patients. Previous large randomised studies comparing albumin with crystalloid solutions failed to show differences in clinical outcomes, such as overall mortality. However, if crystalloids are to be used, clinicians need to decide whether to use saline or a balanced solution. Balanced solutions (Hartmann's solution or Plasma‐Lyte in Australia) have a sodium, potassium and chloride content similar to that of extracellular fluid and may have lesser impact on acid‐base balance.

This issue has been recently studied by the Balanced Solution versus Saline in Intensive Care Study (BaSICS) trial, which compared normal saline to Plasma‐Lyte. The study found no overall difference in 90‐day mortality or in any other clinical outcomes.

This MJA perspective shares more. 

Learning Outcomes

1. Explain key components of the perspective
2. List main findings
3. Identify four key aspects of critical care to support improved patient outcomes.

Details

Author: Yasmine Ali Abdelhamid, Adam Deane and Rinaldo Bellomo

Article Type: Perspective