R.E.B.E.L. EM - 15 October 2015 - By Matt Astin / Post Peer Reviewed By: Salim Rezaie
"Author Conclusion: “Among patients receiving crystalloid fluid therapy in the ICU, use of a buffered crystalloid compared with saline did not reduce the risk of AKI. Further large randomized clinical trials are needed to assess efficacy in higher-risk populations and to measure clinical outcomes such as mortality.”
Clinical Take Home: Although no definitive answer is given to the question of which fluid to give for fluid resuscitation in the critically ill, at the moment it seems you are safe if you still want to use 0.9% saline or low-chloride crystalloid solutions at a volume of 2L or less. Remember the Goldilocks principle: not too much, not too little, but just the right amount. Fluids are a drug and we must monitor the effect they have on patients."
http://rebelem.com/the-split-trial-saline-vs-plasma-lyte-fluid-therapy/