Increased Mortality with Use of Isotonic Saline for Sepsis

Recent preclinical and observational research has demonstrated adverse effects when using isotonic saline versus balanced fluids (i.e., lactated Ringer’s solution or Plasmalyte) for intravenous resuscitation. Raghunathan and colleagues conducted a retrospective cohort study to assess the association between choice of crystalloids and in-hospital mortality during the resuscitation of critically ill adults with sepsis.

They found that resuscitation with balanced fluids was associated with a lower risk of in-hospital mortality. However, generalizing this result could prove difficult since the study excluded pediatric and surgical patients. In addition, some degree of residual confounding is possible due to the observational nature of this work. Additional clinical trials are required to confirm this finding.

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