R.E.B.E.L.EM - By Salim Rezaie - Deceember 05, 2019
..."Author Conclusion: “Among patients with sepsis in a large randomized trial, use of balanced crystalloids was associated with a lower 30-day in-hospital mortality compared to use of saline.”
Clinical Take Home Point: We have stated before on the blog that it makes more physiological sense to use balanced crystalloids in large volume (>2L) resuscitation, and given the weight of evidence if you are using NS or a balanced crystalloid as your resuscitation fluid of choice keep using your fluid of choice. It appears now in this secondary analysis of the SMART trial there appears to be a lower 30d in-hospital mortality with the use of lactated Ringer’s solution vs saline which pushes the needle even further to support use of balanced crystalloids over saline in patients with sepsis."