The safety and efficacy of balanced crystalloid vs. normal saline in non-cardiac surgeries - A systematic review and meta-analysis.

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Fluid Management

Background:

• Balanced crystalloids (BC) and normal saline (NS) are common intraoperative fluids.
• Their comparative safety and efficacy in non-cardiac surgery remain uncertain.

Purpose of the Study:

• To compare the clinical outcomes of balanced crystalloids versus normal saline in non-cardiac surgeries.
• To evaluate effects on acidosis, renal function, mortality, and electrolyte balance.

Main Methods:

• A meta-analysis of 43 randomized controlled trials (RCTs) was conducted.
• Searched databases included PubMed, Embase, Web of Science, Cochrane Library, Wanfang, and CNKI (1980-2023).
• Primary outcomes: acidosis, renal insufficiency, mortality. Secondary outcomes: pH, electrolytes, vasopressor use.

Main Results:

• Balanced crystalloids significantly reduced acidosis compared to normal saline (OR: 0.05, p=0.00).
• No significant differences were found in renal insufficiency or mortality between BC and NS.
• BC use led to higher pH and lower Na+/Cl- levels postoperatively.

Conclusions:

• Perioperative balanced crystalloids help maintain acid-base and electrolyte balance, reducing acidosis.
• Balanced crystalloids do not appear to reduce postoperative renal insufficiency or mortality compared to normal saline.