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|Title:||Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults.||Austin Authors:||Finfer, Simon;Micallef, Sharon;Hammond, Naomi;Navarra, Leanlove;Bellomo, Rinaldo ;Billot, Laurent;Delaney, Anthony;Gallagher, Martin;Gattas, David;Li, Qiang;Mackle, Diane;Mysore, Jayanthi;Saxena, Manoj;Taylor, Colman;Young, Paul;Myburgh, John||Affiliation:||Intensive Care..
George Institute for Global Health, Sydney, Australia..
Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australia..
Central Clinical School, University of Sydney, Sydney, Australia..
Intensive Care Unit, Royal Prince Alfred Hospital, Sydney, Australia..
Department of Intensive Care, St. George Hospital, Sydney, Australia..
Intensive Care Unit, Bankstown Hospital, Sydney, Australia..
University of New South Wales, Sydney, Australia..
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia..
Department of Critical Care, University of Melbourne, Melbourne, Australia..
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia..
School of Public Health, Imperial College London, London, UK..
Medical Research Institute of New Zealand, Wellington, New Zealand..
Department of Intensive Care, Wellington Regional Hospital, Wellington, New Zealand..
Northern Clinical School, University of Sydney, Sydney, Australia..
|Issue Date:||3-Mar-2022||Date:||2022-01-18||Publication information:||The New England journal of medicine 2022; 386(9): 815-826||Abstract:||Whether the use of balanced multielectrolyte solution (BMES) in preference to 0.9% sodium chloride solution (saline) in critically ill patients reduces the risk of acute kidney injury or death is uncertain. In a double-blind, randomized, controlled trial, we assigned critically ill patients to receive BMES (Plasma-Lyte 148) or saline as fluid therapy in the intensive care unit (ICU) for 90 days. The primary outcome was death from any cause within 90 days after randomization. Secondary outcomes were receipt of new renal-replacement therapy and the maximum increase in the creatinine level during ICU stay. A total of 5037 patients were recruited from 53 ICUs in Australia and New Zealand - 2515 patients were assigned to the BMES group and 2522 to the saline group. Death within 90 days after randomization occurred in 530 of 2433 patients (21.8%) in the BMES group and in 530 of 2413 patients (22.0%) in the saline group, for a difference of -0.15 percentage points (95% confidence interval [CI], -3.60 to 3.30; P = 0.90). New renal-replacement therapy was initiated in 306 of 2403 patients (12.7%) in the BMES group and in 310 of 2394 patients (12.9%) in the saline group, for a difference of -0.20 percentage points (95% CI, -2.96 to 2.56). The mean (±SD) maximum increase in serum creatinine level was 36.6±94.0 μmol per liter (0.41±1.06 mg per deciliter) in the BMES group and 36.1±90.2 μmol per liter (0.41±1.02 mg per deciliter) in the saline group, for a difference of 0.5 μmol per liter (95% CI, -4.7 to 5.3) (0.01 mg per deciliter [95% CI, -0.05 to 0.06]). The number of adverse and serious adverse events did not differ meaningfully between the groups. We found no evidence that the risk of death or acute kidney injury among critically ill adults in the ICU was lower with the use of BMES than with saline. (Funded by the National Health and Medical Research Council of Australia and the Health Research Council of New Zealand; PLUS ClinicalTrials.gov number, NCT02721654.).||URI:||https://ahro.austin.org.au/austinjspui/handle/1/28652||DOI:||10.1056/NEJMoa2114464||ORCID:||0000-0002-2785-5864
|Journal:||The New England journal of medicine||PubMed URL:||35041780||PubMed URL:||https://pubmed.ncbi.nlm.nih.gov/35041780/||Type:||Journal Article|
|Appears in Collections:||Journal articles|
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