ReviewCritical care (London, England)2010
A balanced view of balanced solutions.
Review in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02520804 (Effect of Normal Saline Versus Balance Salt Solution Resuscitation on Kidney Function; A Randomized Open Label Controlled Study), which is not on this map. Cited by 64 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Normal Saline Versus Balance Salt Solution Resuscitation on Kidney Function; A Randomized Open Label Controlled Study
Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 201 citations in OpenAlex.
- Terms, Definitions, Nomenclature, and Routes of Fluid Administration.Frontiers in veterinary science · 2020Pooled it
- Meta-analysis of high- versus low-chloride content in perioperative and critical care fluid resuscitation.The British journal of surgery · 2015Pooled it
- Trial
- Acid/base alterations during major abdominal surgery: 6% hydroxyethyl starch infusion versus 5% albumin.Korean journal of anesthesiology · 2018Trial
- Trial
- Liberal or restricted fluid administration: are we ready for a proposal of a restricted intraoperative approach?BMC anesthesiology · 2014Trial
- Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial.BMC medicine · 2013Trial
- Trial
- Machine Learning-Driven Prediction, Preparation, and Evaluation of Functional Nanomedicines Via Drug-Drug Self-Assembly.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Role of Crystalloids in the Perioperative Setting: From Basics to Clinical Applications and Enhanced Recovery Protocols.Journal of clinical medicine · 2023Review
- Issuing of isotonic crystalloid solutions to Danish public hospitals in 2021-A retrospective nationwide observational study.Acta anaesthesiologica Scandinavica · 2023Observational
- The efficacy of sodium bicarbonated Ringer's solution versus lactated Ringer's solution in elderly patients undergoing gastrointestinal surgery: a prospective randomized controlled trial.American journal of translational research · 2023Article
- Electrolyte derangements in critically ill children receiving balanced versus unbalanced crystalloid fluid resuscitation.BMC nephrology · 2022Observational
- Intravenous Fluid Administration and the Risk of Adverse Outcomes in Sickle Cell Disease Patients Hospitalized for Vaso-Occlusive Crisis.Journal of hematology · 2022Review
- Balanced Crystalloids versus Normal Saline in Adults with Sepsis: A Comprehensive Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Review
- The effects of bicarbonated versus acetated Ringer's solutions on acid-base status and kidney injury following orthotopic liver transplantation: Protocol for a single-centre, randomised controlled trial (The BETTER trial).Frontiers in surgery · 2022Article
- The effect of acetate Ringer's solution versus lactate Ringer's solution on acid base physiology in infants with biliary atresia.BMC pediatrics · 2021Article
- Influence of acetate containing fluid versus lactate containing fluid on acid-base status, electrolyte level, and blood lactate level in dehydrated dogs.Veterinary world · 2021Article
- Fluid overload due to intravenous fluid therapy for vaso-occlusive crisis in sickle cell disease: incidence and risk factors.British journal of haematology · 2021Article
- Zero-Balance Ultrafiltration during Cardiopulmonary Bypass Is Associated with Decreased Urine Output.The journal of extra-corporeal technology · 2021Article
4 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
7 authors at 7 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The present review of fluid therapy studies using balanced solutions versus isotonic saline fluids (both crystalloids and colloids) aims to address recent controversy in this topic. The change to the acid-base equilibrium based on fluid selection is described. Key terms such as dilutional-hyperchloraemic acidosis (correctly used instead of dilutional acidosis or hyperchloraemic metabolic acidosis to account for both the Henderson-Hasselbalch and Stewart equations), isotonic saline and balanced solutions are defined. The review concludes that dilutional-hyperchloraemic acidosis is a side effect, mainly observed after the administration of large volumes of isotonic saline as a crystalloid. Its effect is moderate and relatively transient, and is minimised by limiting crystalloid administration through the use of colloids (in any carrier). Convincing evidence for clinically relevant adverse effects of dilutional-hyperchloraemic acidosis on renal function, coagulation, blood loss, the need for transfusion, gastrointestinal function or mortality cannot be found. In view of the long-term use of isotonic saline either as a crystalloid or as a colloid carrier, the paucity of data documenting detrimental effects of dilutional-hyperchloraemic acidosis and the limited published information on the effects of balanced solutions on outcome, we cannot currently recommend changing fluid therapy to the use of a balanced colloid preparation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.