Hemodynamics, fluids & transfusion
Comparison of balanced and unbalanced crystalloids as resuscitation fluid in patients treated for cardiogenic shock
Authors' conclusion
In patients with cardiogenic shock, use of balanced crystalloids was associated with a similar all-cause mortality at 30 days but a lower rate of new onset of renal replacement therapy. In the subgroup of patients after OHCA with severe shock, use of balanced crystalloids was associated with a higher mortality than saline.
Study context
- Population
- Patients with cardiogenic shock with or without out-of-hospital cardiac arrest (OHCA), Munich University Hospital, 2010–2022propensity score matched
- Participants
- 1,032 patients
- Exposure
- 0.9% saline vs balanced crystalloids as resuscitation fluid
- Salinen = 516reference
- Balanced crystalloidsn = 516
- Outcome
- 30-day mortality rate
- Follow-up
- 30 days
Methodological detailspropensity-score matched, single-centre registry
- Propensity-score matched
- Single-centre registry
Main finding
As reported in the abstract
P = 0.833
Observational data: associations, not effects.
Further findings
New onset RRT
P = 0.007
30-day mortality, OHCA with lactate >7.4 mmol/L (subgroup)
P = 0.013
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| Mortality after OHCA (multivariate Cox regression)Independently associated | 1.43 (1.05–1.96) | P = 0.024 | |
| 0.512Hazard ratio (log scale) |
Catecholamine doses
- Significantly higher doses of catecholamines with saline
Original publication
Comparison of balanced and unbalanced crystalloids as resuscitation fluid in patients treated for cardiogenic shock. J Intensive Care. Published 6 September 2023. doi:10.
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