Do balanced crystalloids versus saline decrease the risk of adverse outcome events in noncritically ill adults?

BEEM Bottom Line

Why is this study important?

Normal saline ([NS] 0.9% sodium chloride) solution is a commonly used replacement fluid but has a 50% higher chloride concentration than plasma and is thought to cause metabolic acidosis and acute kidney injury (AKI). Balanced crystalloids such as lactated Ringer’s solution have a chloride concentration much closer to plasma, and; therefore, might be safer. This trial, part of a larger trial of critically ill adults, seeks to determine if administering intravenous (IV) balanced crystalloids to noncritically ill patients in the emergency department (ED) compared to NS reduced their risk of adverse outcomes.[1]

Which, if any, threats to validity are most likely to have an impact on the results and how?

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