Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults
Type of article: In Brief
MedED Catalogue Reference: MCC007
Cross Reference: Fluid Management, Critical Care, Emergency Medicine
Keywords: multi-electrolyte solution, BMES, renal-replacement therapy
Sources: NEJM
New research published in the NEJM this week, presents the findings of a double-blind, randomized, controlled trial that aimed to determine whether the use of balanced multielectrolyte solution (BMES) instead of saline as fluid therapy in critically ill patients reduces the risk of acute kidney injury or death.
The study involved 5,037 critically ill patients from 53 intensive care units in Australia and New Zealand. The patients were randomly assigned to receive either BMES (Plasma-Lyte 148) or saline as fluid therapy for 90 days. The primary outcome was death from any cause within 90 days, and secondary outcomes included the initiation of renal-replacement therapy and the maximum increase in serum creatinine levels during the ICU stay.
The results showed that there was no significant difference in the risk of death within 90 days between the BMES group and the saline group. Both groups had a similar percentage of deaths. Additionally, there was no significant difference in the initiation of renal-replacement therapy or the maximum increase in serum creatinine levels between the two groups. The incidence of adverse and serious adverse events was similar in both groups as well.
In conclusion, the study found no evidence to suggest that the use of BMES instead of saline reduces the risk of death or acute kidney injury in critically ill adults in the ICU. These findings suggest that there may not be a clear advantage to using BMES over saline as fluid therapy in this patient population.
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