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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Thursday, August 12, 2021

Normal saline and balanced IV fluids

First10EM - By Justin Morgenstern - August 11, 2021
Do you have strong opinions about normal saline? If so, you might need a hobby, but also this paper is for you. The BaSICS trial is a massive RCT with more than 10,000 patients comparing normal saline to a balanced crystalloid IV fluid.
The paper
Zampieri FG, Machado FR, et al. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. JAMA. 2021 Aug 10. doi: 10.1001/jama.2021.11684. PMID: 34375394 [free full text]
Bottom line
This is the best and largest study of normal saline and balanced IV fluids to date, and it is pretty clear that normal saline is as safe as the balanced fluid. (Whether providing either IV fluid to these patients is beneficial is a completely different question.) Continue to use whatever is easiest for your team. I still almost always use saline myself.