ReviewCritical care science2026
Balanced crystalloids versus saline for critically ill patients: an overview of systematic reviews.
Review in Critical care science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo provide an overview of the evidence comparing the use of balanced crystalloids and normal saline in critically ill patients.
methodsA comprehensive literature search was conducted in PubMed®, Embase, and Cochrane databases through July 2024. Systematic reviews with meta-analyses comparing balanced crystalloids versus normal saline in critically ill patients were included. The methodological quality of the included reviews was assessed using the AMSTAR-2 tool.
resultsFourteen systematic reviews published between 2018 and 2024 met the inclusion criteria. Key clinical outcomes evaluated included mortality, acute kidney injury, and initiation of renal replacement therapy. Patient subgroups analyzed encompassed sepsis, trauma, hypovolemia, traumatic brain injury, postoperative status (cardiac and non-cardiac), and elderly populations. The methodological quality assessment of reviews using AMSTAR-2 revealed that most reviews had critical weaknesses in one or more domains. Quality appraisal revealed that one review had no critical domain weaknesses, while 13 reviews exhibited limitations in these domains. Evidence synthesis indicated a small benefit of balanced crystalloids compared to normal saline, especially among patients with sepsis and those without traumatic brain injury.
conclusionThis overview of systematic reviews suggests a small clinical advantage of balanced crystalloids over normal saline in critically ill patients, particularly in subgroups such as those with sepsis.
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