Saline versus Lactated Ringer's Solution: The Saline or Lactated Ringer's (SOLAR) Trial. (April 2020)
- Record Type:
- Journal Article
- Title:
- Saline versus Lactated Ringer's Solution: The Saline or Lactated Ringer's (SOLAR) Trial. (April 2020)
- Main Title:
- Saline versus Lactated Ringer's Solution
- Authors:
- Maheshwari, Kamal
Turan, Alparslan
Makarova, Natalya
Ma, Chao
Esa, Wael Ali Sakr
Ruetzler, Kurt
Barsoum, Sabri
Kuhel, Alan G.
Ritchey, Michael R.
Higuera-Rueda, Carlos
Kopyeva, Tatyana
Stocchi, Luca
Essber, Hani
Cohen, Barak
Suleiman, Iman
Bajracharya, Gausan R.
Chelnick, David
Mascha, Edward J.
Kurz, Andrea
Sessler, Daniel I. - Abstract:
- Abstract : Background: Both saline and lactated Ringer's solutions are commonly given to surgical patients. However, hyperchloremic acidosis consequent to saline administration may provoke complications. The authors therefore tested the primary hypothesis that a composite of in-hospital mortality and major postoperative complications is less common in patients given lactated Ringer's solution than normal saline. Methods: The authors conducted an alternating cohort controlled trial in which adults having colorectal and orthopedic surgery were given either lactated Ringer's solution or normal saline in 2-week blocks between September 2015 and August 2018. The primary outcome was a composite of in-hospital mortality and major postoperative renal, respiratory, infectious, and hemorrhagic complications. The secondary outcome was postoperative acute kidney injury. Results: Among 8, 616 qualifying patients, 4, 187 (49%) were assigned to lactated Ringer's solution, and 4, 429 (51%) were assigned to saline. Each group received a median 1.9 l of fluid. The primary composite of major complications was observed in 5.8% of lactated Ringer's versus 6.1% of normal saline patients, with estimated average relative risk across the components of the composite of 1.16 (95% CI, 0.89 to 1.52; P = 0.261). The secondary outcome, postoperative acute kidney injury, Acute Kidney Injury Network stage I–III versus 0, occurred in 6.6% of lactated Ringer's patients versus 6.2% of normal saline patients,Abstract : Background: Both saline and lactated Ringer's solutions are commonly given to surgical patients. However, hyperchloremic acidosis consequent to saline administration may provoke complications. The authors therefore tested the primary hypothesis that a composite of in-hospital mortality and major postoperative complications is less common in patients given lactated Ringer's solution than normal saline. Methods: The authors conducted an alternating cohort controlled trial in which adults having colorectal and orthopedic surgery were given either lactated Ringer's solution or normal saline in 2-week blocks between September 2015 and August 2018. The primary outcome was a composite of in-hospital mortality and major postoperative renal, respiratory, infectious, and hemorrhagic complications. The secondary outcome was postoperative acute kidney injury. Results: Among 8, 616 qualifying patients, 4, 187 (49%) were assigned to lactated Ringer's solution, and 4, 429 (51%) were assigned to saline. Each group received a median 1.9 l of fluid. The primary composite of major complications was observed in 5.8% of lactated Ringer's versus 6.1% of normal saline patients, with estimated average relative risk across the components of the composite of 1.16 (95% CI, 0.89 to 1.52; P = 0.261). The secondary outcome, postoperative acute kidney injury, Acute Kidney Injury Network stage I–III versus 0, occurred in 6.6% of lactated Ringer's patients versus 6.2% of normal saline patients, with an estimated relative risk of 1.18 (99.3% CI, 0.99 to 1.41; P = 0.009, significance criterion of 0.007). Absolute differences between the treatment groups for each outcome were less than 0.5%, an amount that is not clinically meaningful. Conclusions: In elective orthopedic and colorectal surgery patients, there was no clinically meaningful difference in postoperative complications with lactated Ringer's or saline volume replacement. Clinicians can reasonably use either solution intraoperatively. Abstract : In a large single-center alternating cohort trial of patients having elective colorectal or orthopedic surgery, there was no clinically meaningful difference in the risk of a composite of in-hospital mortality and major postoperative complications including renal, respiratory, infectious, and hemorrhagic complications.Supplemental Digital Content is available in the text. … (more)
- Is Part Of:
- Anesthesiology. Volume 132:Number 4(2020)
- Journal:
- Anesthesiology
- Issue:
- Volume 132:Number 4(2020)
- Issue Display:
- Volume 132, Issue 4 (2020)
- Year:
- 2020
- Volume:
- 132
- Issue:
- 4
- Issue Sort Value:
- 2020-0132-0004-0000
- Page Start:
- Page End:
- Publication Date:
- 2020-04
- Subjects:
- Anesthesiology -- Periodicals
Anesthetics -- Periodicals
Anesthesia -- Periodicals
617.9605 - Journal URLs:
- http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=toc&D=yrovft&AN=00000542-000000000-00000 ↗
http://www.mdconsult.com/public/search?search_type=journal&j_sort=pub_date&j_issn=0003-3022 ↗
http://www.anesthesiology.org ↗
http://journals.lww.com ↗
http://journals.lww.com/anesthesiology/pages/default.aspx ↗ - DOI:
- 10.1097/ALN.0000000000003130 ↗
- Languages:
- English
- ISSNs:
- 0003-3022
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 0900.600000
British Library DSC - BLDSS-3PM
British Library STI - ELD Digital store - Ingest File:
- 18730.xml