Balanced crystalloids versus saline and mortality in hospitalized patients: a hierarchical Bayesian meta-analysis of cluster-randomized trials.

In 30 seconds

This hierarchical Bayesian meta-analysis evaluated the effectiveness of balanced crystalloids versus saline in hospitalized patients across six cluster-randomized trials involving 42,223 patients. The analysis found a pooled relative effect for mortality of 0.92, indicating an 83% posterior probability of benefit, but no clear reduction in mortality or acute kidney injury (AKI).

Key findings

• Pooled Bayesian relative effect for mortality was 0.92 (95% CrI 0.77-1.18).
• There was an 83% posterior probability of benefit for mortality.
• Pooled Bayesian relative effect for AKI was 1.02 (95% CrI 0.86-1.23).
• There was a 40% posterior probability of benefit for AKI.

Why it matters

Understanding the effectiveness of fluid management strategies is crucial for optimizing patient outcomes in critical care settings. This analysis provides insights into the real-world implications of using balanced crystalloids versus saline.