Table 1 Characteristics of the fluids assessed and qualitative summary from this network meta-analysis
Components | Plasma | Balanced crystalloid | Saline | Albumin (Iso-/Hyperoncotic) | L-HES | Gelatin |
|---|---|---|---|---|---|---|
Osmolarity (mOsm/kg) | 291 | Hypotonic (254–273) | Isotonic (286) | Hypotonic (4%, 260; 5%, 250; 20%, 200; 25%, 250) | Isotonic to Hypertonic (283–304) | Isotonic to Hypertonic (274–301) |
Na/Cl (mmol/l) | 140/103 | 130–140/98–111 | 154/154 | 130–160/128–130 | 137–154/110–154 | 145–154/120–145 |
K/Ca (mmol/l) | 40/4 | 4–5/2–2.7 | 0/0 | < 2/0 | 0–4/0–2.5 | 0–5.1/0–6.25 |
Conditions | Outcome | Balanced crystalloid | Saline | Albumin | L-HES | Gelatin |
|---|---|---|---|---|---|---|
Sepsis | NMA results | Lowest mortality Lowest acute kidney injury Lowest transfusion volume More fluid volume required | Higher mortality More fluid volume required | Lower mortality (Iso-oncotic) Least fluid volume required | Highest mortality More acute kidney injury More transfusion volume | |
Comments | Fluid of choice for sepsis | Not favored for sepsis | Iso-oncotic albumin for sepsis patients with risk of fluid overload | Not favored for sepsis | Require further trials | |
Surgery | NMA results | Most fluid volume required Lower acute kidney injury | More fluid volume required More blood transfusion volume | Lower mortality (Hyper-oncotic) Less fluid volume required Less acute kidney injury Less blood transfusion volume | Highest mortality Less fluid volume required | Less fluid volume required |
Comments | More favored for surgery | Less favored for surgery | Favored for surgery | Not favored for surgery | Require further trials | |
Trauma | Mortality | Lower mortality Less acute kidney injury Less transfusion volume More fluid volume required | Lower mortality More acute kidney injury More transfusion volume | Higher mortality Less acute kidney injury Less transfusion volume | Higher mortality | |
Comments | More favored for trauma | Damage control resuscitation. May consider blood products for resuscitation | ||||
Traumatic brain injury (TBI) | Mortality | Higher mortality | Lower mortality | Highest mortality (Iso-oncotic) | Lowest mortality | |
Comments | Hypotonic solution was not suggested for TBI | Favored for TBI | Iso-oncotic albumin with hypotonic solution was not favored for TBI | May consider for TBI | Require further trials |