Fewer Adverse Kidney Events in Patients Who Are Given Balanced Crystalloids

What is the right crystalloid for fluid resuscitation? Because limited data guide this decision, choices traditionally have been driven by culture: saline in medical units, and lactated Ringer's solution for surgical patients. With emerging evidence showing that the hyperchloremia associated with administration of normal saline might cause harm, interest in the effects of various crystalloids has increased.

During 2 years in two parallel studies, investigators at Vanderbilt University assigned patients to receive either normal saline or a more-balanced crystalloid solution (i.e., lactated Ringer's or Plasma-Lyte). One cohort comprised 15,802 patients who were admitted to the intensive care unit (ICU), and the other cohort comprised 13,347 pa…