SCCM Resource Library-Is It SMART to Give Balanced Crystalloids or Are We Still SPLIT on the BaSICS of Fluid?

Is It SMART to Give Balanced Crystalloids or Are We Still SPLIT on the BaSICS of Fluid?

Video Transcription

Video Summary

The speaker, a senior author of a related study, discussed the importance of fluid composition in critically ill patients, highlighting potential biases due to their involvement in the research. They reviewed several major randomized controlled trials (RCTs) assessing balanced fluids versus saline, noting methodological differences that might explain varying results. The SMART trial used balanced fluids in ICU settings, observing a potential benefit, though results were small. The BASICS and PLUS trials, using different methods, found no significant outcome differences. The speaker emphasized the timing of fluid administration and pre-enrollment factors as potentially impactful, particularly noting how initial fluid compositions could influence patient outcomes before ICU admission. Despite small observed effects on mortality, a meta-analysis suggested balanced fluids were preferable over saline for most critical patients, barring traumatic brain injury cases. The speaker stressed the significance of early fluid choice due to the high volume of patients receiving IV fluids annually.

Asset Caption

One-Hour Concurrent Session | When New Data Conflict With Old Data: Making Sense Through the Lens of Landmark Trials

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

fluid composition

critically ill patients

randomized controlled trials

balanced fluids

ICU settings

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