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Related Experiment Video

Updated: Jul 2, 2025

Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury

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ACETATE RINGER'S SOLUTION VERSUS NORMAL SALINE SOLUTION IN SEPSIS: A RANDOMIZED, CONTROLLED TRIAL.

Jing Zhang, Fang Liu, Ziyi Wu

¹Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Shock (Augusta, Ga.)

|February 18, 2024

Summary

Ringer's acetate solution (RAS) and normal saline solution (NSS) showed no significant difference in major adverse kidney events for sepsis patients. Further research is needed to clarify fluid resuscitation effects in critical care.

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Area of Science:

Critical Care Medicine
Nephrology
Intensive Care

Background:

Normal saline solution (NSS) and Ringer's acetate solution (RAS) are standard intravenous fluids for critically ill patients.
The comparative impact of RAS and NSS on sepsis patient outcomes, particularly kidney function, is not well-established.

Purpose of the Study:

To investigate the effect of RAS versus NSS on major adverse kidney events within 28 days (MAKE28) in adult sepsis patients.
To evaluate secondary outcomes including mortality, acute kidney injury, and hyperchloremia.

Main Methods:

A single-center, prospective, open-label, parallel controlled trial involving adult sepsis patients.
Patients received either RAS or NSS intravenously for five days.
Primary outcome: MAKE28; Secondary outcomes: 30-/90-day mortality, acute kidney injury, hyperchloremia. Post hoc analysis included fluid groups (RAS-only, NSS-only, RAS + NSS).

Main Results:

No statistically significant difference in MAKE28 between the RAS and NSS groups (23.3% vs. 20.0%; P = 0.69).
Post hoc analysis also showed no significant difference in MAKE28 between RAS-only and NSS-only groups (23.3% vs. 27.3%; P = 0.65).
Patients receiving NSS-only experienced longer mechanical ventilation and a trend towards higher serum chloride levels.

Conclusions:

Neither RAS nor NSS demonstrated a statistically significant difference in MAKE28 or other secondary outcomes for sepsis patients.
The influence of pre-ICU fluid resuscitation and the use of NSS as a carrier fluid may have obscured potential differences between balanced salt solutions and NSS.