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Saline may raise risk of death and kidney complications more than balanced crystalloids

BMJ 2018; 360 doi: (Published 28 February 2018) Cite this as: BMJ 2018;360:k950
  1. Susan Mayor
  1. London

Using saline as intravenous fluid treatment is associated with a higher risk of death and kidney complications than balanced crystalloid solutions in critically and non-critically ill adults admitted to hospital, two pragmatic randomised studies have shown.12 But a commentator warned that more research is needed before changing practice.

Intravenous resuscitation fluids are among the most common medical treatments in hospitals and are used routinely in emergency departments, hospital wards, intensive care units, and operating theatres.

Commonly used crystalloid solutions are saline (0.9% saline), which has a higher chloride concentration than plasma, and balanced crystalloids that contain additional anions, such as lactate or acetate, to act as physiological buffers to achieve near …

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