Xuan Song1, Huairong Wang2, Xinyan Liu1, Xiuyan Guo2, Baiqing Yu3, Nana Zhang1. 1. ICU, DongE Hospital Affiliated to Shandong First Medical University, Liaocheng, China. 2. Education Department, DongE Hospital Affiliated to Shandong First Medical University, Liaocheng, China. 3. Emergency Department, DongE Hospital Affiliated to Shandong First Medical University, Liaocheng, China.
Abstract
BACKGROUND: Studies have shown complications of normal saline infusion because of its high-chloride content. Therefore, in the present study, we aimed to explore whether the use of low- versus high-chloride solutions benefited the unselected and specifically perioperative patients and was associated with different outcomes. METHODS: Studies on the use of low- versus high-chloride content intravenous solutions for perioperative patients, published up to July 15, 2019, were systematically reviewed, and primary and secondary outcomes were quantitatively summarized. RESULTS: A total of 14 eligible randomized controlled trials with 943 perioperative patients were included. Five studies reported all-cause mortality, and eight studies provided detailed data on renal replacement therapy (RRT). The pooled result suggested no statistically significant difference in the effect of low- versus high-chloride solutions on all-cause mortality (risk ratio (RR) = 1.39; 95%confidence interval (CI) = 0.23-8.26) and RRT (RR = 1.05; 95%CI = 0.63-1.76). The pooled results on acute kidney injury (AKI) and the use of allogenic blood transfusion (P > 0.05) were similar. CONCLUSION: Among specific perioperative patients, the use of low- versus high-chloride content intravenous solutions did not reduce the all-cause mortality, risk of severe AKI, or rate of RRT use. Further large randomized clinical trials are needed to confirm or refute this finding.
BACKGROUND: Studies have shown complications of normal saline infusion because of its high-chloride content. Therefore, in the present study, we aimed to explore whether the use of low- versus high-chloride solutions benefited the unselected and specifically perioperative patients and was associated with different outcomes. METHODS: Studies on the use of low- versus high-chloride content intravenous solutions for perioperative patients, published up to July 15, 2019, were systematically reviewed, and primary and secondary outcomes were quantitatively summarized. RESULTS: A total of 14 eligible randomized controlled trials with 943 perioperative patients were included. Five studies reported all-cause mortality, and eight studies provided detailed data on renal replacement therapy (RRT). The pooled result suggested no statistically significant difference in the effect of low- versus high-chloride solutions on all-cause mortality (risk ratio (RR) = 1.39; 95%confidence interval (CI) = 0.23-8.26) and RRT (RR = 1.05; 95%CI = 0.63-1.76). The pooled results on acute kidney injury (AKI) and the use of allogenic blood transfusion (P > 0.05) were similar. CONCLUSION: Among specific perioperative patients, the use of low- versus high-chloride content intravenous solutions did not reduce the all-cause mortality, risk of severe AKI, or rate of RRT use. Further large randomized clinical trials are needed to confirm or refute this finding.
Authors: C A Pfortmueller; G-C Funk; C Reiterer; A Schrott; O Zotti; B Kabon; E Fleischmann; G Lindner Journal: Br J Anaesth Date: 2017-12-02 Impact factor: 9.166
Authors: Claudia M Simões; Maria J C Carmona; Ludhmila A Hajjar; Jean-Louis Vincent; Giovanni Landoni; Alessandro Belletti; Joaquim E Vieira; Juliano P de Almeida; Elisangela P de Almeida; Ulysses Ribeiro; Ana L Kauling; Celso Tutyia; Lie Tamaoki; Julia T Fukushima; José O C Auler Journal: BMC Anesthesiol Date: 2018-05-09 Impact factor: 2.217