Saudi Cultural Missions Theses & Dissertations
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Item Restricted The use of balanced crystalloids versus 0.9% normal saline among critically ill patients(Saudi Digital Library, 2023-11-01) Alotaibi, Amjad; Al-Haddad, MoBackground: Intravenous (IV) fluid administration is a fundamental element of critical care management. Balanced crystalloids and 0.9% normal saline are commonly used for resuscitation and maintenance among critically ill patients. However, the impact of fluid composition on critically ill patient outcomes remains uncertain. Aim: The current systematic literature search aimed to assess, through a comparison with 0.9% normal saline, whether the use of balanced crystalloids for resuscitation and maintenance reduces the mortality rate of critically ill patients. Methods: On June 6, 2023, a comprehensive systematic literature search was carried out by using the MEDLINE (OVID), Embase (OVID), Cochrane Library, CINAHL (EBSCOhost), and Scopus databases. Predefined study selection criteria were formulated to select the relevant articles. Results: The search yielded 2,614 articles. Seven studies—three randomised controlled trials with a total of 31,891 patients and four cohort studies with a total of 7,969 patients— met the inclusion criteria. The findings of the included studies were inconsistent. Evidence from well-conducted studies showed that, compared to 0.9% normal saline, the use of balanced crystalloids did not lower the mortality rate. The other cohort studies found that the administration of balanced crystalloids reduced the mortality rate. However, the quality of the cohort studies was considered weak based on the existing evidence. Conclusion: Compared to 0.9% normal saline, the use of balanced crystalloids did not decrease the mortality rate of critically ill patients.12 0