Evidence map›Paper›PMID 28861420›Full record

ArticleAnnals of translational medicine2017

Balanced versus isotonic saline resuscitation-a systematic review and meta-analysis of randomized controlled trials in operation rooms and intensive care units.

Ary Serpa Neto, Ignacio Martin Loeches, Robert B Klanderman, Raphael Freitas Silva, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, PROVE Network Investigators

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of translational medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Aiming for zero fluid accumulation: First, do no harm.Anaesthesiology intensive therapy · 2021
    Review
  5. Article
  6. Article
  7. Article
  8. Current aspects in sepsis approach. Turning things around.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2018
    Review
  9. Review
  10. Review
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 5 countries.

Ary Serpa NetoDepartment of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Ignacio Martin LoechesDepartment of Clinical Medicine, St James's Hospital, Multidisciplinary Intensive Care Research Organization (MICRO), Trinity Centre for Health Sciences, Dublin, Ireland.
Robert B KlandermanDepartment of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Raphael Freitas SilvaAnesthesiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Marcelo Gama de AbreuPulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Paolo PelosiDepartment of Surgical Sciences and Integrated Diagnostics, IRCCS San Martino IST, University of Genoa, Genoa, Italy.
Marcus J SchultzDepartment of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
PROVE Network Investigators
Hospital Israelita Albert Einstein · BRAmsterdam UMC Location University of Amsterdam · NLIstituti di Ricovero e Cura a Carattere Scientifico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluid resuscitation is the cornerstone in treatment of shock, and intravenous fluid administration is the most frequent intervention in operation rooms and intensive care units (ICUs). The composition of fluids used for fluid resuscitation gained interest over the past decade, with recent focus on whether balanced solutions should be preferred over isotonic saline.

methodsSystematic review and meta-analysis of randomized controlled trials (RCTs) comparing fluid resuscitation with a balanced solution versus isotonic saline in adult patients in operation room or ICUs. Primary outcome was in-hospital mortality, secondary outcomes included occurrence of acute kidney injury (AKI) and need for renal replacement therapy (RRT).

resultsThe search identified 11 RCTs involving 2,703 patients; 8 trials were conducted in operation room and 3 in ICU. In-hospital mortality, as well as the occurrence of AKI and need for RRT was not different between resuscitation with balanced solutions versus isotonic saline, neither in operation room nor in ICU patients. Serum chloride levels, but not arterial pH, were significantly lower in patients resuscitated with balanced solutions.

conclusionsCurrently evidence insufficiently supports the use of balanced over isotonic saline for fluid resuscitation to improve outcome of operation room and ICU patients.

Indexed as

Balanced solutionchloridefluid resuscitationintensive care unit (ICU)isotonic salinemeta-analysisnormal salineoperation roomsystematic review

Identifiers

PMID28861420
PMCPMC5566736
OpenAlexW2745060852

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.