Zampieri FG, Machado FR, Biondi RS, et al. - The use of a balanced solution vs 0.9% saline solution did not significantly reduce 90-day mortality in critically ill patients requiring fluid challenges. The findings indicate that this balanced solution should not be used.

• A total of 10,520 (95.2%) of the 11,052 patients that were randomized were available for analysis (mean age, 61.1 [SD, 17] years; 44.2% were women).

• No significant interaction was found between the 2 interventions (fluid type and infusion speed).

• Planned surgical admissions accounted for 48.4% of all patients.

• At the time of enrollment, 60.6% of the patients had hypotension or were using vasopressors, and 44.3% required mechanical ventilation.

• During the first day after enrollment, patients in both groups received a median of 1.5 L of fluid.

• By day 90, 1,381 of 5,230 patients (26.4%) assigned to a balanced solution had died, compared with 1,439 of 5,290 patients (27.2%) assigned to saline solution.

• In either group, there were no unexpected treatment-related severe adverse events.