Hemodynamics, fluids & transfusion
Effect of Treatment With Balanced Crystalloids Versus Normal Saline on the Mortality of Critically Ill Patients With and Without Traumatic Brain Injury: A Systematic Review and Meta-Analysis
Authors' conclusion
In comparison to normal saline, balanced solutions were associated with a reduction in mortality in critical care patients without TBI. However, balanced solutions were associated with an increase in mortality in patients with TBI.
Study context
- Population
- Adult critical care patients with and without traumatic brain injury (TBI)
- Participants
- 35,207 patients · 15 clinical trials
- Comparison
- Balanced crystalloids vs normal saline
- Outcome
- Mortality, in patients with and without TBI
- Follow-up
- 90 days
Methodological detailsrandom-effects model, PRISMA
- Random-effects model
- PRISMA
Pooled result
As reported in the abstract
Mortality
Balanced solutions vs SalineOdds ratio (95% CI)P value
Patients without TBI; I 2 = 0%
0.93(0.87–0.98)
P = 0.01Patients with TBI; I 2 = 0%
1.31(1.03–1.65)
P = 0.03Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Mortality (sepsis subgroup)I 2 = 0% | 0.92 (0.83–1.02) | |
| 0.512Odds ratio (log scale) |
Hospital LOS, renal complications, need for vasopressors or mechanical ventilation
- No differences due to fluid choice; pooled estimates unavailable for some secondary outcomes in TBI patients
Original publication
Effect of Treatment With Balanced Crystalloids Versus Normal Saline on the Mortality of Critically Ill Patients With and Without Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Anesth Analg. Published 20 January 2025. doi:10.
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