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Comment & Response
April 12, 2016

Acute Kidney Injury With Buffered Crystalloids vs Saline Among ICU Patients

Author Affiliations
  • 1Medical Intensive Care Unit, University of Kentucky HealthCare, Lexington
  • 2Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kentucky HealthCare, Lexington
JAMA. 2016;315(14):1519. doi:10.1001/jama.2016.0145

To the Editor A concern regarding the 0.9% Saline vs Plasma-Lyte 148 for ICU Fluid Therapy (SPLIT) trial is the use of normal saline as a ubiquitous diluent for medication delivery in critical care.1 It is not uncommon for patients who are critically ill to receive more than 1 L of normal saline daily from medications alone, not including fluids prescribed for resuscitation or other indications. This amount of normal saline has the potential to diminish the effect size if a difference existed between the normal saline and buffered crystalloid groups.

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