Evidence map›Paper›PMID 39971001›Full record

Trial reportChest2025

Normosol-R vs Lactated Ringers in the Critically Ill: A Randomized Trial.

Edward T Qian, Ryan M Brown, Karen E Jackson, Li Wang, Joanna L Stollings, Robert E Freundlich, Jonathan P Wanderer, Edward D Siew, Gordon R Bernard, Wesley H Self and 4 more

Registry-linked trialAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Chest, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03537898 (Balanced Solutions and Plasma Electrolytes in the Medical Intensive Care Unit), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT03537898 nacompletednot on this map

Balanced Solutions and Plasma Electrolytes in the Medical Intensive Care Unit

TypeinterventionalSponsorVanderbilt University Medical CenterRan2018 to 2019Enrolled2,093ConditionsCritical Illness, Acidosis, MetabolicArmsLactated Ringer's, Normosol
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Clarithromycin for treating sepsis in adults.The Cochrane database of systematic reviews · 2026
    Article
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

14 authors.

Edward T QianDepartment of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Nashville, TN; Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN. Electronic address: edward.t.qian@vumc.org.
Ryan M BrownAsheville Pulmonary and Critical Care Associates, Asheville, NC.
Karen E JacksonDivision of Pulmonary, Critical Care, and Sleep Medicine, Rush University Medical Center, Chicago, IL.
Li WangDepartment of Biostatistics, Vanderbilt University, Nashville, TN.
Joanna L StollingsDepartment of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN.
Robert E FreundlichDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN.
Jonathan P WandererDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN.
Edward D SiewDepartment of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Tennessee Valley Health Systems (TVHS), Nashville Veterans Affairs Hospital, Nashville, TN.
Gordon R BernardDepartment of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN.
Wesley H SelfVanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
Jonathan D CaseyDepartment of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Nashville, TN.
Todd W RiceDepartment of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN.
Matthew W SemlerDepartment of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research (VICTR), Vanderbilt University Medical Center, Nashville, TN.
Pragmatic Critical Care Research Group

Funding

Clinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0M
Bag-Mask Ventilation to PreVent Hypoxemia during Tracheal Intubation in the Emergency Department: A Clinical TrialK23HL153584 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CASEY, JONATHAN DALE · 2020 to 2024
$900k
NHLBI NIH HHS K23 HL153584NHLBI NIH HHS T32 HL087738
6 · The paper itself

Abstract

backgroundBalanced crystalloid solutions may improve clinical outcomes compared with saline for some critically ill adults, but it is unclear whether differences in composition between balanced crystalloid solutions affect outcomes. RESEARCH QUESTION: Does the choice of balanced crystalloid solutions (Normosol-R vs lactated Ringers) impact acid-base status, organ function, or outcomes for critically ill adults? STUDY DESIGN AND

methodsThis pragmatic, cluster-randomized, multiple-crossover trial at an academic medical center in the United States compared the use of Normosol-R vs lactated Ringers among critically ill adults. The primary outcome was the plasma bicarbonate (HCO

resultsBetween June 1, 2018, and January 31, 2019, 2,084 patients were enrolled. The median age was 59 years, 1,006 patients (48.3%) were female, and the median Sequential Organ Failure Assessment score was 5 (interquartile range, 3-8). HCO

interpretationAmong critically ill adults, the use of Normosol-R for IV fluid therapy did not affect plasma HCO CLINICAL

trial registrationClinicalTrials.gov; No.: NCT03537898; URL: www. CLINICALTRIALS: gov.

Indexed as

Critical IllnessCrystalloid SolutionsFluid TherapyRinger's LactateAcid-Base EquilibriumAgedBicarbonatesCross-Over StudiesFemaleHumansMaleMiddle AgedRenal Replacement TherapyBicarbonatesCrystalloid SolutionsRinger's Lactatebalanced crystalloidbicarbonatecritical illness

Identifiers

PMID39971001
PMCPMC12405922

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.