[e-drug] Saline Solution (0.9%) versus Ringer's lactate (cont'd)

[Joel Lexchin <joel.lexchin@utoronto.ca>]

E-drug: Saline Solution (0.9%) versus Ringer's lactate (cont'd)
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There don't appear to be any controlled trials comparing normal
saline and lactated Ringers that I can find. However, there is a
1999 meta-analysis that looked at crystalloids versus colloids
(Crystalloids vs. colloids in fluid resuscitation: A systematic review.
Choi, Peter T-L. MD, FRCPC. Yip, Gordon MD. Quinonez, Luis G.
MD. Cook, Deborah J. MD, FRCPC, MSc(Epid), Critical Care
Medicine 1999;27(1):200-210). There were a variety of crystalloids
used including Ringers and normal saline. The conclusion of the
meta-analysis was that no evidence-based recommendations could
be reached regarding whether to use crystalloids or colloids. The
authors did not make any comment about whether one crystalloid
was better than another. In the emergency departments where I
have worked in Canada we always use normal saline as the initial
fluid for resuscitation and then switch to blood products. We don't
use Ringers.

Joel Lexchin MD
121 Walmer Rd.
Toronto Ontario
Canada M5R2 2X8
Tel: +1-416-964-7186
Fax: +1-416-923-9515
e mail: joel.lexchin@utoronto.ca

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